HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5-31-16 Permit Number:
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
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 5263 AMY LANE
Legal Description: GREEN ACRES UNIT TWO S/D BLK 3 LOT 7 (OR 3642-324)
Property Tax ID #: 1430-701-0023-000-3
Site Plan Name:
Project Name: ROBERT OTTONE
Setbacks Front Back:
Right Side: Left Side:
F1
Lot No. 7
Block No. 3
DETAILED DESCRIPTION OF WORK: III
Install new green pole service including riser and meter can. Re -hook existing square D electrical
panel, conduits and wires.
CONSTRUCTION INFORMATION: III
HVAC L I Gas Tank
Electric 1:1 Plumbing
Total Sq. Ft of Construction: _
Cost of Construction: $ 1348.00
Piping
Sprinklers
apply:
Shutters
Generator
5Ft. of First Floor: _
Utilities: Sewer []Septic
❑ Windows/Doors
Roof
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ROBERT OTTONE & PATRICIA HUNT
Name: CHRISTOPHER W. RICHMOND
Address: 5263 AMY LANE
Company: RICHMOND ELECTRIC, INC
City: FORT PIERCE State: FL
Zip Code: 34946 Fax: 772-461-1907
Phone No.
Address: 3086 ENTERPRISE ROAD
City: FORT PIERCE State: FL
Zip Code: 34982 Fax: 772-461-1907
Phone No. 772-461-1951
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
VEGETATION
Address:
City:
Zip: Phone:
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Address:
REVIEW
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 contlict 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
commencine work or recordine vour Notice of Commencement.
_ Signature of wner/ Lessee/Agent Sign ure of Con actor/License Holder
STATE OF FLORIDA
COUNTY OF ST LUCIE
The forgoing instrument was acknowledged before me
this 3f day of 20by
STATE OF FLORIDA
COUNTY OF ST LU—
The forgoing instrument was acknowledged before me
this3/dayofAlat4 20 Z by
CHRISTOPHER W. RICHMOND CHRISTOPHER W. RICHMOND
(Name of person acknowledging) (Name of person acknowledging )
Personally Known x
Type of Identification
Commission No. FF
Revised 07/1
OR Produced Identification
Publk State o/ Fsxga
M Daitev
Expires 08112/2019
Notary
Personally Known x OR Produced Identification
Type of Identification Produced
Commission No.
NcWY notltll;'9tate of FIta1Ea
Deana M Dailey
My ccmm'.,.( FF a11af100
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS