HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8/17/16 Permit Number:-'' I
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Building Permit Application I
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
PRQPOSED 1MPRO.VEM'NT LOCATI;QN
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
Setbacks Front Back: Right Side: Left Side:
s� �g
D NAILED DESGRIP3{ ION Q,F WR'K.. f �F � 3
INSTALL SINGLE PHASE 120/240V, 200A OVERHEAD ELECTRIC SERVICE:FOR SHOP AREA.
CflNSTRUCTIhaN INFORNIATIO'N
Arlditonal wor toe e orme under tis —checkpermit a appy:
HVAC 17 Gas Tank []Gas Piping M_Shutters Q Windows/Doors
❑✓_Electric ❑Plumbing Sprinklers ElGenerator E] Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ 900.00 Utilities: Sewer 0 Septic Building Height:
C+1N4UER/LESSEE u {CONTRACTOR: �,� j � ' , A. ,
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Name DAMIECKI REALTY INVESTMENTS LLC Name: CHRISTOPHER W.RICHMOND
Address:1400 S. ICEAN 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: E60001963
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
7777,77 —777
SUPPLEMENTAL CONSTRUCTION LIEN LAIN 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.
_Signature of wner/Lessee/Agent Signature of Con actor/License Holder
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 day of A:Axa I��_ 20 bo this��day of 20 J t4L by
CHRISTOPHER W.RICHMOND CHRISTOPHER W.RICHMOND
(Name of person acknowledging) (Name of person acknowledging)
i
(Signature of Notary Public-State of Flo a) Signature of Notary Public-State of Floficla)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
v*"� Notary ��q State of Florida
Commission No"— g Commission Noll=
Dean Pi'Nailey NotaryPublic State of Florida
pP� My Commission FF 909099 ' Deana M Dailey
Revised 07/15/2014 ofr� ;F-xPires08H 2/2019
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS