HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED n
Date: January!-23- 2- 017 —"�, 9-7 /7 Permit Number: / / L
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Building Permit Application JAIL 2 7 2017
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)46211553 Fax: (772)462-1578 Commercial X Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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PR,�POSED 1 ;PROUEMEN'f LOCATI �N ='' � %i/ � /� /
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Address: V�C U P_0-Q k_ Eb o i~i` -Q► CICGC 3 41?
Legal Description: 23 34 40 GOVT LOT 2-LESS THAT PART ASSESSED IN QUEEN'S COVE ACCESS RD S/D AND LESS
THAT PART ASSD IN QUEEN'S COVE UNITS 2 AND 3 AND LESS THAT PART ADJ ON S OF LOT 22 BLK 25 QUEEN'S COVE
Property Tax ID#: 11423-220-0000-000-8 Lot No.
Site Plan Name: I Block No.
Project Name: IMP. 19A
Setbacks Front i Back: Right Side: Left Side:
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D 'AILED DE ;�RIPTION ,° F WORK '! / ;
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REPLACING EXISTING OVERHEAD'RISER ANDWEATHERHEAD. LIKE FOR LIKE
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INFORIVTION ///,/, / � 4 /a„ /
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Add
rtiona workt Tlertormed under this permit–check all appy:
HVAC Gas Tank E]Gas Piping _Shutters a Windows/Doors
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❑✓_Electric ❑ Plumbing Sprinklers 1:1 Generator ❑ Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ 600.00 Utilities: Sewer Septic Building Height:
OIiVNER/LESS , 'CONTRACT%R
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Name ST. LUCIE COUNTY Name: CHRISTOPHER W. RICHMOND
Address: 2300 VIRGINIA AVENUE Company: RICHMOND ELECTRIC, INC
City: FORT PIERCE State: FLAddress: 3086 ENTERPRISE ROAD
Zip Code: 34982 I Fax. 772-461-1907 City: FORT PIERCE State:FL
Phone No. 772-461-1951 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.
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U CEMENT, CONST ,CTIO Ltd
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: I Phone: Zip: Phone:
FEE SIMPLE TITLES HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: I Address:
City: City:
Zip: I 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,lswimming 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.
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_Signature of Owner/Lessee/Agent Signature of Contractor/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&q day of S 20 J(pby this day of 20 1b by
CHRISTOPHER W.RICHM ND CHRISTOPHER W.RICHMOND
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary' Public-State of Voricla) (Signature of Notary Public-State of FlororT
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Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. FF 909 Commission No. FFsosc , Notat�e
ate of FloridayPo_ Deaey =o0` �n Notary Public State of Florida
My GerAm Deana M Daile
orM10 Expires 08/12/2019 ` My Commission FF 909099
Revised 07/15/201orao�° Expires 08/1212019
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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