HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6-29-15 Permit Number: if7
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Building Permit Application JUN 3 0 20`
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1.578 Commercial Residential x
PERMIT APPLICATION FOR: Electrical
PROPOSED,.IMPFtQUEMENT tC7CATi;ON '`
Address: 1700 EDGEVALE RD, FORT PIERCE,34982
Legal Description: MARAVILLA PLAZA BLK 1 LOT 14 AND E 112 OF LOT 15(0.22 AC)
Property Tax ID#: 2421-802-0014-000-2 Lot No.
Site Plan Name: Block No.
Project Name: PANEL REPLACEMENT
Setbacks Front Back: Right Side: Left Side:
dTAICED DESCRiPTI0Ii1 OF WORK; {
REPLACEMENT OF EXISTING 100 AMP FUSE PANEL WITH A SQUARE D BREAKER PANEL.
PANEL IS FED BY EXISTING MAIN DISCONNECT BREAKER TO REMAIN NEXT TO THE
METER CAN.
QNTRUCTiON.,INFOR
MATIN
Additional work toe a orme under t is permit—check a �appy:
HVAC 11 Gas Tank ❑Gas Piping _Shutters l]Windows/Doors
Electric F] Plumbing Sprinklers []Generator Roof
Total Sq. Ft of Construction: S�Ft.(of First Floor:
Cost of Construction:$ 912.00 Utilities."n Sewer F]Septic Building Height:
OWN\ERjLESSEE _ CONTRACTOR
Name JEAN J HARGETT Name: 'r0v,,7-fS
Address:1700 EDGEVALE RD Company: RICHMOND ELECTRIC INC
City: FT PIERCE State:FIS Address: 3086 ENTERPIRISE RD
Zip Code: 34982 Fax: City: FT PIERCE State:FL
Phone No.461-0963 Zip Code: 34982 Fax: 772-461-1907
E-Mail: Phone No. 772-461-1951
Fill in fee simple Title Holder on next page(if different E-Mail: CASEY@RICHMONDELECTRICINC.COM
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from the Owner listed above) State or County License: CCOOD lq5*' c�-.r� /0 Sly
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENI"AL CONSI"RUCTIQN LiEN:LAW iN,FC)RMATIaiV
. ... . . _
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: `Not Applicable BONDING COMPANY: Not Applicable
Name: Name'
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing,consult with lender or an attorney before
'commencing work or recording our Notice of Commencement.
S
_Signature of Owner/Lessee/Agent ature of ContractorJLicense Holder
STATE OF FLORIDA STATE OF FLORI A
COUNTY OF COUNTY OF
The rgoing inst was acknowledged fore me The forgoing instr n�roas acknowledged before me
this day of 20J, S:by this,"day of ,� 201S�
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Vtary Public-State of Flo ida) (Signature of NcIfary Public-State of Florida)
Personally Known of OR Produced Identification Personally Known ell--OR Produced Identification
Type of identification Produced Type of Identification Produced
Commission No. Seal) Commission No. Seal)
. :ol'Ay •rp"••
-iR`�Y:v ,• AUDREY 8.HUM '+'PHREY ;r. AUDREY 8.HUMPHREY
kAV-
EXPIRES;March 6,2019 %. a
EXPIRES:
i3;•. o; •..•.;e• MarCitti,2019
Revised 07/15/2014 '�,q °' banded Thru Notary Publlo Underwriters 9f d�•` Bond lacy public Undetwraers
REVIEWS FRONT ZONING SUPERVISOR PIANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS