HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5/24/16 Permit Number:
� � 1
j' Building Permit Application
Planning and Development Services
j Building and Code Regulation Division
1300 Virginia Avenue, Fort Pierce FL 34981
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
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�I PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 2705 QUAIL ROAD
' 203540 FROM NE COR OF NE 1/4 OF NE 1/4 OF SW1/4 RUN W200FT,THS 19FT FOR POB,THWI5 FT, THS 185 FT THW185 FT, THS78.15 FT,
Legal D25C(IptlOn:
TN E 185 FT TO STAKE INRo THS 78.15 FT WL, TH E 15". TH NMI 3FT TO POB Nr) (0.45 AC) (IXt 28062118: 29gde4. 2896510: 30442810: 37951031: 37952513; 3815987: Wl" ; 3841-3839)
Property Tax ID p: 2420-311-0003-010-5 Lot No.
Site Plan Name: Block No.
Project Name:
i Setbacks Front Back. Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
INSTALL 120 VOLT CIRCUIT IN CONDUIT FROM EXTERIOR ELECTRICAL PANEL TO PUMP
I MOTOR CONTROL.
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CONSTRUCTION INFORMATION:
Additional work to be ertormerl under this permit — check all apply:
i HVAC � Gas Tank ❑Gas Piping _ Shutters ❑Windows/Doors
ZElectric 0 Plumbing ❑Sprinklers ❑ Generator ❑ Roof
Total Sq. Ft of Construction:
Cost of Construction: $ 600.00
' OWNER/LESSEE:
S� 'F�tj. of First Floor:
Utilities: uSewer ❑Septic
Name CHRISTINE & KEIRA GREEN
Address: 2705 QUAL ROAD
City: FORT PIERCE State: FL
Zip Code: 34981 Fax: 772-461-1951
Phone No.
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
ICONTRACTOR:
Building Height:
Name: CHRISTOPHER W. RICHMOND
Company: RICHMOND ELECTRIC, INC
Address: 3086 ENTERPRISE ROAD
City: FORT PIERCE State: FL
Zip Code: 34982 Fax: 772-461-1907
Phone No. 772-461-1951
E -Mail: DEANA@RICHMONDELECTRICINC.COM
State or County License: EC0001963
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
t City:
State: City: State:
Zip: Phone:
_
Zip: Phone:
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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
I commencing work or recording your Notice of Commencement.
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i1/%C/ ��' f C t/ —- s
i _Sig ature of 0 er/ Lessee/Agent Signature of Contra or/License Holder
STATE OF FLORIDA
COUNTY OF ST. LUCIE
The forgoing instrument was acknowledged before me
thisaday offfe2 j , 20 (>Qby
CHRISTOPHER W. RICHMOND
(Name of person acknowledging )
I Pu1 Public -
)2 Q
- ('gnature of otary Public- State of Ftl a )
Personally Known x I
Type of Identification P eiR a Notary P-Wic State d Fronds
_ '3c My Commission FF 909099
Commission No. FF090 90 Extarc>I9la1a/2019
Revised 07/15/2014
REVIEWS FRONT ZONING
=� COUNTER REVIEW
DATE
COMPLETE
INITIALS
STATE OF FLORIDA
COUNTY OF ST. LUCIE
The forgoing instrument was acknowledged before me
this 2-Y day of '* z/-
20 46 b
CHRISTOPHER W. RICHMOND
(Name of person acknowledging )
,x.& — (14 :I)
(Signature of Notary Public- State of Florida
Personally Known x
Type of Identificatioi
Commission No. FF909099
Deana M Dailey
Myanion FF 909099
Es 1 Meyes 1212019
SUPERVISOR PLANS VEGETATION I SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW