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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: '• L� Permit Number: RECEIVED JAN 21 2020 Building Permit Application Planning and Development Services ST. Lucie County,,Permitting. Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: �P�R©POSED II111PRQVEMENT`L�CATIQNw�� 9,���� �� ��, w u3 � Address: 636 NETTLES BLVD Property Tax ID#: 4502-501-0822-000-9 Lot No.636 Site Plan Name: Block No. Project Name: x t� ., {g r � ,�'�'E ,y s� 1 ' 'si•h' &4-�.Y� ir?3 k.e 1 g'3 Ali DEQ RIPTI©N @>r YV RK w —u 3.a _ stip' A `t h�:�*h, "� sk ,.u. Install a new 20 amp 120 volt receptacle in new customer supplied enclosure plus/minus 5ft.from the existing power supply GC3NSTRUCTIDN INFORMATIC}R , Additional work to be performed under this permit—check all that apply: _Me anical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ 255 Utilities: —Sewer _Septic Building Height: , WNER�LESSEE41 `�� CONTpACTf1R b � ., .,.,>,, F..,.„S r. .}4� <>�,s s Name Terry L Benedict Name:EDWARD D. FLACK Address:637 Nettles Blvd Company:KILOWATT ELECTRIC COMPANY City: Jensen Beach State: FL Address: 1700 NW 22ND AVE Zip Code: 34957-3346 Fax: City: POMPANO BEACH State:FL Phone No.248-877-5409 Zip Code: 33069 Fax: 954-975-9946 E-Mail: Phone No 954-975-8200 Fill in fee simple Title Holder on next page(if different E-Mail EDDIE_FLACK@KILOWATT-ELECTRIC.COM from the Owner listed above) State or County License EC13001961 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required. h`-` �"-vRR CC s .°, •`sz :-j 'ciaRst^n ,�., ;.,: „� (�/�y: i ry '�-&" EWA! �� :s'a _ +'P. y'.i .�} ,�i,t, a• k'a� .�. S: .;nu� DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: X Not Applicable Name:N/A Name:NIA Address:NIA Address: NIA City: State: City: N/A State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: X Not Applicable Name:NIA Name:NIA Address:N/A Address: NIA City:NIA City:N/A Zip: Phone: Zip: Phone: OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated. 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 thepermit 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 CO NCEMENT MUST BE RECORDED AND POSTED ON T �JOEBEFORE THE FIRST INSPECTION. IF YOU N O IN FINANCING, CONSULT WITH YOU ATTORNEY BEFORE RECORDING YOUR O MMENCEMENT." A V,�� Signat r f Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF BROWARD COUNTY OF BROW- The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 16 day of JANUARY 20 20 by this 16 day of JANUARY 20 20 by Name of person making statement. Name of person making statement. Personally Known OR Produceden i ica ion ersona Type of Identification Type of Identification Produced '�'�—� L Produced Notary Public Siata of Florida (Signature of Nota iy��s igItu reof Notary Public- �y owl araiorr » D` 023 ala 01/01/2@23 .��wY FU td1S5I N#GG 022 Commission Nd",',,',',, 1g,2r}20 IRES:De d Commission No. ca. c two -M Hot2ry Publil '"i'W N-21 Bonded N REVIEWS RONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.