HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5-31-16
Permit Number:
iI J
•
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
1300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 8601 SANTA CLARA BLVD
Legal Description: LAKEWOOD PARK - UNIT 8-B-BLK 3 LOT 2 (MAP 13/02N) (OR 3836-2705)
Property Tax ID #: 1301-610-0030-000-9
Site Plan Name:
Project Name: REMAX
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Lot No. 2
Block No. 3
Replace bathroom exhaust fan, kitchen ballast and lamps. Install tamper resist GFCI receptacles in
kitchen and bathrooms. Install ceiling boxes for open wiring in both guest bedrooms.
HVAC Q Gas Tank
ZElectric El Plumbing
Total Sq. Ft of Construction: _
Cost of Construction: $ 1227.00
Piping LJ Shutters ❑Windows/Doors
nklers Generator 11 Roof
S. Ft. of First Floor:
Utilities: Sewer ElSeptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name US BANK TRUST NA (TR) C/O CALIBER HOME LOANS
Address: 13801 WIRELESS WAY
Name: CHRISTOPHER W. RICHMOND
Company: RICHMOND ELECTRIC, INC
City: OKLAHOMA CITY State: OK
Zip Code: 73134 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
it varve or construction is >LbUU or more, a KtcoitutU notice of commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Signature of Co tractor/License Holder
Address:
City:
Zip: Phone:
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Address:
CHRISTOPHER W. RICHMOND
Address:
City:
(Name of person acknowledging )
City:
Zip: Phone:
Personally Known x OR Produced Identification
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.
Revised 07/15/20 ar ExpiM0al12/2019 ptiC Exrpir"IW12/2019
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_ Signature of Owner/ Lessee/Agent
Signature of Co tractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF ST LUCIE
COUNTY OF ST LUCIE
The forgoing inst`r�ym�)�en�t wa�s acknowledged before me
The forgoing instrument was acknowledged before me
this L day of L 20 f 4 by
this , day of 20 � by
CHRISTOPHER W. RICHMOND
CHRISTOPHER W. RICHMOND
(Name of person acknowledging)
(Name of person acknowledging )
(Signature of Notary Public- State of Flo a )
(Signature of Notary Public- State of F106(a )
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification Produced
Type of Identification Produced
Commission No. FF 90
Commission No. r>=eoeos9
Dlpyry Public Stara d FkwWa
Nwary Pd�Ne Stas, d Fkwim
Deana M Dalley
Y Deana M Dailey
Revised 07/15/20 ar ExpiM0al12/2019 ptiC Exrpir"IW12/2019
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INITIALS