HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE CO PLETED FOR APPLICATION TO BE ACCEPTED
7-8-15 '9 l
Date: L J Permit Number:
Y r .-J
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: BLIND CREEK(AIA SOUTH BEA0,H) 5-103 13
Legal Description:
Property Tax ID#:'z - -GGTD0=7– T y— 3` 0 o O L%No.
Site Plan Name: Block No.
Project Name: MOSQUITO CONTROL BLIND CREEK 5 NORTH 7 I/a i,7W
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK.:
REPLACE DAMAGED 200 AMP THREE PHASE METER CAN - LIKE FOR LIKE
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit–check all that appy:
❑HVAC Gas Tank ❑Gas Piping ❑Shutters ❑Windows/Doors
❑✓_Electric ❑ Plumbing ❑Sprinklers ❑Generator ❑ Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 1000.00 Utilities:[]Sewer OSeptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name ST LUCIE CO MOSQUITO CONTROL Name: THOMAS RICHMOND
Address:3150 WILL FEE ROAD Company: RICHMOND ELECTRIC INC
City: FT PIERCE State:FL Address: 3086 ENTERPRISE RD
Zip Code: 34982-5652 Fax: City: FT PIERCE State:FL
Phone No. Zip Code: 34982 Fax: 772-461-1951
E-Mail: Phone No. 772-461-1951
Fill in fee simple Title Holder on next page if different E-Mail: CASEY@RICHMONDELECTRICINC.COM
from the Owner listed above) State or County License: EC0001458
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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 theermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or andicovenants 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 your Notice of Commencement.
Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SCOUNTY OF
The f ing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this Vday of U7,Q A-1 20 W-by this-15 day of =-'O. 20&_by
(Name of person acknowledging) (Name of person acknowledging)
(Sigratu?e of Notary Public-Statdf Florida) -Sio4atdre of Notary Public- to of Florida
Personally Known OR Produced Identificatio Personally Known OR Produced Identification
Type of Identification Produced— - - Type of Identification Produced
0'S"Nhli of Florida
�c-State
Commission No. 14ota66ZO es Dee 20,20AB Commission No. (SEiA$HAHNA INGRAM
-S Comm- State of Florida
A77249 Notary Public
MY • My Comm.Expires Dec 20,201 f
missitart'on
Commission# FF 177249
OF,
toed ttitou
OF,
Revised 07/15/201 Bonded through National Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
-COMPLETE
INITIALS