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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE 1IN'FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: l 'a L4. px) Permit Number: �Io1- 0 t � 1 _ + � Building Permit Applicatio RECEVl=5 Planning and Development Services JAN 2 4 2020 Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 ST. Lucie County, Permitting Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residen Ia PERMITTYPE: PROPOSED IMPROVEMENT LOCATION , k "`# �. �f Address: 1224 NETTLES BLVD Property Tax ID#.. 4502-501-1411-000-2 Lot No.1224 Site Plan Name: Block No. Project Name: :DETAILED�DESCRIPTi©N C}I=WORKts� '' � '���� Install a new 20 amp 120 volt receptacle in new customer supplied enclosure plus/minus 5ft.from the existing power supply sCONSTRI�C10N I�U'I=ORMATIO.N wP 'M � �< Additional work to be performed under this permit-check all that apply: V7 Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors V 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: OWNRLESSEE ,;� s COIF RAC lR , �, �, o Name Rosemarie Leloia Name:EDWARD D. FLACK Address: 1224 NETTLES BLVD Company:KILOWATT ELECTRIC COMPANY City: Jensen Beach State: FL Address: 1700 NW 22ND AVE Zip Code: 34957-3396 Fax: City: POMPANO BEACH State:FL Phone No. 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. S�U'PP�EMENT�AL:CONSTRr �I�ON LIEN �W kN�FORMA'rT'1QN: `�• � � � " DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x—Not Applicable Name:NIA Name:NIA Address:NIA Address: NIA City: State: City: NIA State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x Not Applicable Name:NIA Name:NIA Address:NIA Address: NIA City:NIA City:NIA 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 COMMENCEMENT MUST BE RECORDED AND POSTED ON jJIEi JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTPRD TO OBTAIN FINANCING, CONSULT WITH YOU PUNDER 9A ANATT E RECORDING YOUR NO F CO NCEMENT." Signat r f Owner/Lessee/Contractor as Agent for Owner SignatuLelbf 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 ,ZQ 20 by this 16 day of.JANUARY 2020 by Name of person making statement. Name of person mak70R tatement. Personally Known P o c d ti is Up Personally Known Produced Identification Type of Identification Type of Identification r Notary Pubko State of Florida YP Produced . rinse Produced My Com scene rms 287788u�, Notary Public State of Flor' or w ��01/01/2023 r ;9 Diane E Gariirtghouse M My Commission GG 2877811 or w� Expires 01/01IM23 ignature of Notary Public-State of Florida) (Signature of Notary Public-St r Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.