HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: _n _ Permit Number: 200 a4c(�
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Building Permit Application JAN 21 202.0
Planning and Development Services
Building and Code Regulation Division ST. Lucie Co nty., Permittingr
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMITTYPE:
m PROPOSED iMPROVEMEN`f LOCATI , N .a '" ,..... _'., �" r
Address: 304 NETTLES BLVD
Property Tax ID#: 4502-501-0490-000-2 Lot No.304
Site Plan Name: Block No.
Project Name:
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TL t7E5CRIPTION 0 WORK '
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Install a new 20 amp 120 volt receptacle in new customer supplied enclosure plus/minus 5ft.from the existing power supply
C�NSTRUCT(ON INF;004 11� 'ION, Y s
Additional work to be performed under this permit–check all that apply:
_Mec nical _Gas Tank _Gas Piping _Shutters _Windows/Doors
lectric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 255 Utilities: —Sewer _Septic Building Height:
WNERjLESSEE s U, 44.
CONTRACTOR'
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Name Harry L Young JR) Name:EDWARD D. FLACK
Address:825 Nettles blvd Company:KILOWATT ELECTRIC COMPANY
City: Jensen Beach State: FL Address: 1700 NW 22ND AVE
Zip Code: 34957-3365 Fax: City: POMPANO BEACH State:FL
Phone No.772-800-3392 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.
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DESIGNER/ENGINEER: x— Not Applicable MORTGAGE COMPANY: x Not Applicable
Name:N/A Name:N/A
Address:N/A Address: N/A,
City: State: City: N/A State:
Zip: Phone Zip: Phone:
FEE.SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x Not Applicable
Name:N/A Name:N/A
Address:N/A Address: N/A
City:N/A 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 JO BEFORE THE FIRST INSPECTION. IF YOU N O IN FINANCING, CONSULT
WITH YOU R AN ATTORNEY BEFORE RECORDING YOUR O MMENCEMEIII
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 BRoWARD
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 ,2020 by
Name of person making statement. Name of person making statement.
Personally Known OR Produceden i ica ion erson Orl--Produced IdentintdLIU11 --
Type of Identification Type of Identification
Produced V\--Z L Produced
any PubUe Sbaaw of Plorld�
(Signature of Notary �y��i5
41tgnVture of Notary Public- o $I ' �
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Commission No gy�GM?�ISS12424 Commission No.
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REVIEWS RONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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