HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /�
Date: �,•3•,7 Permit Number: �02– _01X21
RECEIVED - -
D i
Building Permit Applicatio FEB 0 4 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: �,, ,�
PROPOSED IMPROVENhf NTLOCATION:
Address: 1329 NETTLES BLVD
Property Tax ID#: 4502-501-1516-000-8 Lot No.1329
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORKS -
Install a new 20 amp 120 volt receptacle in new customer supplied enclosure plus/minus 5ft.from the existing power supply
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
WIElectric _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': CONTRACTOR:
Name Joseph Swanson Name:EDWARD D.FLACK
Address: 1475 COUNTY ROAD 125 Company:KILOWATT ELECTRIC COMPANY
City: Northville State: NY Address: 1700 NW 22ND AVE
Zip Code: 12134 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.
SUP PtV4EN"fAE CUNIt3C11710114 1.iEN I AVI/lNi=ORMATtC1N
DESIGNER/ENGINEER: x—Not Applicable MORTGAGE COMPANY: x Not Applicable
Name:IWA Name:WA
Address WA Address: wA
City: State: City: MA —State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: —x Not Applicable
Name:NA �^ Name:IVA
Address:wA Address..2!A_
City:MA City:wA
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 Count�make no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict wit►any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Nome 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]:HE,JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INT_W TO OBTAIN FINANCING, CONSULT
WITH YOUIWILENDER Oft AN AT—TOMEX BEFORE RECORDING YOUR N0,ME,OF COMMCEMENT."
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 BeowARo
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this Is day of imvARY 20 20 by this 1s day of JANUARY .242? by
Name of person makings� taatement. Name of person makingstatement.
Personal! Known P o c d d ti i t'o Personally Known _ OR Produced Identification
Y
Type of Identification ,0Y Pubta Stma of Flat a Type of Identification
Produced Garunpouse Produced
my CWntAi^� : =Iii ,yr �. Nehrypu4NC$Lr4Ra!fbri
^'� Ea�ires 011almi � I' ` Diene$8a� 9d
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af► •y t �f6WrA2'33 my com"Usim Go 2Q77
ignature of Notary Public-State of Florida) (Signature of Notary Public-Stor IV
n
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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