HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11-28-16 Permit Number:
-2000�
•
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
PRO, SED IMPROVEMENT LOCATION:
Address: 110 GODWIN ROAD
Legal Description: 7 35 39 S 352.40 FT OF N 985 FT OF W 1/2 OF SW 1/4 OF NW 1/4 -LESS W 46FT - (4.96 AC)
(OR 727-1619:1289-772)
Property Tax ID 0: 2307-232-0003-000-2 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
REPLACE EXISTING GREEN POLE. REUSE EXISTING METER CAN, HUB, RISER,
WEATHERHEAD & CONDUCTORS.
ONSTRUCTION INFORMATION:
Adaruomn worK toe e orme un ert upermrt—c ec a appy:
Gas Tank ❑Gas Piping Shutters Windows/Doors
❑�
�JJHVAC
II��_II
RElectric OPlumbing Sprinklers 11
Generator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 1687.00 Utilities: Sewer D Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name WILLIAM E. YATES
Name: CHRISTOPHER W. RICHMOND
Address: 3086 ENTERPRISE ROAD
Company: RICHMOND ELECTRIC, INC
City: FORT PIERCE State: FL
Address: 3086 ENTERPRISE ROAD
Zip Code: 34982 Fax: 772461-1907
City: FORT PIERCE State: FL
Phone No. 772461-1951
Zip Code: 34982 Fax: 7721-1907
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
State or County License: EC0001963
from the Owner listed above)
If value of construction Is $2500 or more, a RECORDED Notice of Commencement Is required.
SQPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
Address:
City: State: _
Zip: Phone:
FEE SIMPLE
Name:
Address:
City:
Zip:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
Not Applicable I BONDING COMPANY: _Not
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Counttyy 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 1 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
l/l'✓% e /r I vii �t_ � _ 7 s
_Signature of Owner/ Lessee/Agent Signature of Cqn rector/License Holder
STATE OF FLORIDA
COUNTY OF ST. LUCIE
STATE OF FLORIDA
COUNTY OF aT L.I.
The ffor�DL ing Instrument was acknowledged before me I The forgoing instrument was acknowledged before me
this day of IJ0J&^kzPl20fb by thisy day of NoJe^6.[ 20(Jy by
CHRISTOPHER W. RICHMOND
(Name of person acknowledging I
Personally Known x OR Produced Identification _ Personally Known x OR Produced Identification _
Type of Identification Produced Type of Identification Produced
Commission No.
Revised
Commission No.
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