HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ' • Permit Number:-2no (--o-u-0�
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RECEIVE-
Building
ECEIVEBuildin Permit Application
JAN 2 9 2020
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting -
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMITTYPE:
PR
JP 540IMPROVEMENT tION
Address: 80 NETTLES BLVD
Property Tax ID#: 4502-501-0266-000-3 Lot No.80
Site Plan Name: Block No.
Project Name:
DETA[LED DESCRIPTION
Install a new 20 amp 120 volt receptacle in new customer supplied enclosure plus/minus 5ft.from the existing power supply
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CONSTRUC�"�C}N�INFOR)VIA�TION � � � ` ,���
r
Additional work to be performed under this permit–check all that apply:
Mechanical _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:
;OWN;ER/LESSEETill, kE3R ,
Name Luisa Perez Name:EDWARD D. FLACK
Address:2741 SW 84th CT Company:KILOWATT ELECTRIC COMPANY
City: Miami State: FL Address: 1700 NW 22ND AVE
Zip Code: 33155-2351 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.
-�5'UP MENTAL CflNSTRUCTION LIEN LAW iNFORMATI�
DESIGNER/ENGINEER: x—Not Applicable MORTGAGE COMPANY: x Not Applicable
Name:wA Name:N/A
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:N/A Name:NIA
Address:N/A Address: NIA
City:N/A City N/A
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to clothe 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 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,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 TK JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTgNO TO OBTAIN FINANCING, CONSULT
WITH YOU ER 9A AN ATT E RECORDING YOUR NO FCO 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 BRowAm
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 tatement.
Personally Known R P o c d ti i o Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced t1lr omme Produced
My C rti,WrK iss�n� GG 289TM Nmry PWft State of Fla
aw Erest)trotr2023 DianeEGarrmghouse
My Commission GG 2877
�ro.w t:,�om0trotrM
(Signature of Notary Public-State of Florida} (Signature of Notary Public-StME ul Flui
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 T-7
COMPLETED
Rev. 211119