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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _0 Date: � �- \' Permit Number: DCVO A RECEIVE® Building Permit Application SAN 2 9 2020 Planning and Development Services ST. Lucie Count Permitting Building and Code Regulation Division y, g 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMITTYPE tom' CA r-:1 k i?ROPOSED IMPR6VEMEN ',LQCATIQN Address: 109 NETTLES BLVD Property Tax ID#: 4502-501-0295-000-5 Lot No.109 Site Plan Name: Block No. Project Name: DETAILED ©ESCRIPTION QF WORK7M :., _ ,. � .. �. . _ a' v Install a new 20 amp 120 volt receptacle in new customer supplied enclosure plus/minus 5ft.from the existing power supply T Stp NSTRUCTI,C7N INPORl1l�AT10N ` 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: OWNER/LESSEE R� rc3 s a CUNT CT4R a , 'M r Name Marco LeBlanc Name:EDWARD D. FLACK Address: 15 Rue Oscar Company:KILOWATT ELECTRIC COMPANY City: Gatineau State:QC Address:1700 NW 22ND AVE Zip Code: J8T 21­5 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. SUPP EIVIIENTAL CO'STRUCTtON LIEN LAW INFORMATIO DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable Name:NIA 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:NIA 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 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 Y^JOB SITE BEFORE THE FIRST INSPECTION. IF YOU 1NTqD TO OBTAIN FINANCING, CONSULT WITH YOU NDER OR AN ATT RECORDING YOUR NO F CO NCEMENT.- �J Signat r f Owner/Lessee/Contractor as Agent for Owner Signat 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 20 20 b — — Y Name of person making statement. Name of person making tatement. Personally Known P o c d ti i o Personally Known OR Produced Identification Type of Identification Pulft Stals of Florida Type of Identification Produced jWAN " Produced ± C �287788 e of 'iia w Expires 01101IM3 r ;Q `� Diane E Gaftinghouse ZrM My Commission GG 2877 �io,t►� Expires0l/O1I2023 ignature of Notary Public-State of Florida) (Signature of Notary Public-St 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. 277719