HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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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 Residential X
PERMIT APPLICATION FOR: Electrical
RROPOSED.IIVIPROVEMENT LOCATIQN:
Address: 2417 N OCEAN DRIVE FORT PIERCE
Legal Description: FORT PIERCE SHORES- UNIT 1-BLK 1 LOT 15 AND N 20 FT OF LOT 16 (OR 3756-1876)
Property Tax ID#: 1436-601-0016-000-2 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
S
D'ETAtLED ,DESCR:1PT10WOF WORK:
TEMPORARY POWER POLE
[CONS RU,C.TI,ON hNFORMATI"QN.
Additional work toe oertormed under this permit—check a appy:
HVAC Gas Tank Gas Piping _Shutters Windows Doors
Electric ElPlumbingSprinklers l Generator Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ 300.00 Utilities: Sewer[]Septic Building Height:
OWNER/LESSEE CONTRACTOR.
Name PALM INDIAN PROPERTIES LLC Name: THOMAS RICHMOND
Address:6381 PETERSON ROAD Company: RICHMOND ELECTRIC, INC.
City: FORT PIERCE State:FL Address: 3086 ENTERPRISE ROAD
Zip Code: 34947-4320 Fax: City: FORT PIERCE State:FL
Phone No. 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: DEANA@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.
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WGINEER., Not Applicable „(MORTGAGE COMPANY: Not Applicable
Name. Name:
Address: Address:
City: State. _ ___. City: State:
Zip: Phone; Zip: Phone;
FEE SIMPLE TITLE fIOLDER: Not Applicable BONDING COMPAif1Y: _Not Applicable
Narn : Name:
Address: Address;
City: City
Zip; Phone: zip:—Phone:
i certify that no work or installation has commenced prior to the issuance of;i permit,
St.Lucie Count makes no reppress Cation that is granting a pe mit will authorix10 the ermit holdeCto build the subject structure
which is iri conflict with any:Spplica�le tfar�e Qwri rs As§odat on rules,bylaws or an covenorns that may restrict or prohibit such
structure,Please consult with your Home wners sociatlon and review your deed c r any restrietions which may apply_
In consideration of the granting of this requested pormlt,i do herehy agree that I will,In all respects,perform the work
In accordance with the approved plans,the Florida auililing Codes and St.Lucie County amendments.
The foikoavrng building permit appliettions are exempt from undergoing a full coneurrency review:room additigns,
accessary 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
impprovements to yourpproperty.A Notice of Commencement must be recorded and posted on the jubsite
before the first inspecticln, if you intend to obtaim financing,consult with lender or an attorney before
commencin work cr-recQrding ur Notice of Commencement.
Signature of owner/Lessee/Apr►t Signature of Contractor/license Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF T- Lb%j— COUNTY OFSt.iucae
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this _5 day of 20 I,by this.!—day of„r"rr'AR” 20 by
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(Name of person acknowledging) {Mame of person acknawled$ing}
(Signature o Notary Public.state of rlorida) iSnature of Notary Fu lic State ruced'l-dw
i
Personally Known OR oily Known KW___.�OR;
t" i AL
Type of Identification Produce to ape f identlticntion Produce
RNOT
onald L PerklAS
Commission No., `�32i; b%C0mmisa10 FF a0s3 om ' sion Nc, nonose j, g a,=o0wo
i►a„ Explras 071801201e ex ria otusglzo12
Revised 07/1.5/2014
REVIEWS FRONT Z014ING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW ..,REVIEW REVIEW REVIEW ANEW REViEW
COMPLETE
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