HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: \CAG a, -a\A 2.
T._ RECEIVED FEB 10 2016
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
PROPQSED;IMPROVEM`ENTLOCATION
Address: 4949 N Al APT 82
Legal Description: BREAKERS LANDING UNIT 82 (OR 732-22)
Property Tax ID#: 1414-602-0022-000-2 Lot No.
Site Plan Name: JANE AND DAVID RICE Block No.
Project Name: MR.AND MRS. RICE
Setbacks Front Back: Right Side: Left Side:
RETAILED DESCRIPTION:°OF WORK
HOOK ELECTRIC TO REPLACE WATER HEATER
3
C(JNSTRUCTION INFORMATION
Additionalworkhtoe r)ertormed under this permit—check all that appy:
HVAC Gas Tank ❑Gas Piping _Shutters a Windows DoorsRI ,
Electric a Plumbing Sprinklers 1:1 Generator Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ 200.00 Utilities:Sewer Septic Building Height:
QINNER/LESSEE. ; CONTRACTOR:
_._
Name CHRISTOPHER W. RICHMOND Name: CHRISTOPHER W. RICHMOND
Address:3086 ENTERPRISE ROAD Company: RICHMOND ELECTRIC, INC.
City: FORT PIERCE State:FL Address: 3086 ENTERPRISE ROAD
Zip Code: 34982 Fax:772-461-1907 City: FORT PIERCE State:FL
Phone No.772-461-1951 Zip Code: 34982 Fax: 772-461-1907
E-Mail:DEANA@RICHMONDELECTRICINC.COM 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: EC0001963
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAt CONSTRUCTION L(.EN LAW INFORMATION¥
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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 Signature of Con ractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST.LUCIE COUNTY OF ST.LUCIE
The forgoing instrument was acknowledged j�before me The for Ding instrument was acknowledged before me
this--q—day of 20 !�7 by this day of 20 /6 by
CHRISTOPHER W.RICHMOND CHRISTOPHER W.RICHMOND
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of FI r da) (Signature of Notary Public-State of F da)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Pru Type of Identification Produced
�ppr Pu Notary Public State of Florida
Commission No. FF90909 t° Dear 6(3bQailey Commission No. FF solosw0f)-',
Notary(66W)state of Florida
y�c Q My Commission FF 909099Deana M Dailey
'f w r�o' Expires 08112/2019 My Commission FF 909099
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS