HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED l
Date: 7/12/2016 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 X Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LQCATION
Address: 18801 C 24 CANAL ROAD
Legal Description. 22 36 38 W 1/2-LESS TO SFWMD-(311.40 AC) (OR 1613-938: 3309-1565, 1566)
Property Tax ID#: 3222-211-0001-000-6 Lot No.
Site Plan Name: Block No.
Project Name: DIAMOND TOMATO C-24 NORTH
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCR.IFTlON OF,WORK
3 '
INSTALL 30, 277/480V, 400A, OVERHEAD ELECTRIC SERVICE FOR 100HP IRRIGATION PUMP
CONSTRUCTI„ON INFORMATION
.., .
Additional work to be nerrormed un er t is permit—check a app y:
HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
Electric ❑ Plumbing []Sprinklers ❑Generator ❑ Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 2200.00 Utilities:n Sewer Septic Building Height:
OUVNER/LESSEE ” CONTRACTOR
. ., .
Name DAMIECKI REALTY INVESTMENTS LLC Name: CHRISTOPHER W. RICHMOND
Address: 1400 S. OCEAN BLVD STE N-203 Company: RICHMOND ELECTRIC, INC
City: BOCA RATON State: FL Address: 3086 ENTERPRISE ROAD
Zip Code: 33432 Fax: City: FORT PIERCE State:FL
Phone No. 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.
SUPPLEMENTAL' CONSTRUGTIaN LI; N LAIN INFC3RNiAT1f3N
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:
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,
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
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 Owner/Lessee/Agent Signature of Co tractorJLicense Nolder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST.LUCIE COUNTY OF ST.LUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this J_2,f day of� 20 &by this /Z day of �Iu I W 20 J by
CHRISTOPHER W.RICHMOND CHRISTOPHER W.RICHMOND
(Name of person acknowledging) (Name of person acknowledging)
j
(Signature of Notary Public-State of Rl6rlda} (Signature of Notary Public-State of Flar' )
Personally Known x _ c I e i.a i n Personally Known x OR Produced Identification
Notary Public State of Fion'3tT— Type of identification Produced
Type of Identification q�"� ��.�M -- yp
My Commission FF 909xN r r
Commission No. FF 90 9 FF 90909 �m Note State of Florida
�.+. ,,�' Expires o19 Commission No. ar �g��
—A Deana M Dailey
q My Commission FF 909099
Cgypireq w424204-
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS