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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 2 Date: 1 Permit Number: Q-2 J ,- C 0© • � o Building Permit Application FEB 0 4 2020 ST. Lucie County, Permitting Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 ✓ Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: rte- , PROPOSED IMPROVEMENT LOCATION: Address: 1336 NETTLES BLVD Property Tax ID#: 4502-501-1523-000-0 Lot No.1336 Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION OF WORK: 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 Stacyk LLC Name:EDWARD D.FLACK Address:483 Blackbird Station RD Company:KILOWATT ELECTRIC COMPANY City: Townsend State: DE Address:1700 NW 22ND AVE Zip Code: 19734-9668 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. SUPPLEMENTAL CONST;RUCPON LIEN LAW lfVFCIRtVtATIgN DESIGNER/ENGINEER: x Not Applicable +{ MORTGAGE COMPANY: x Not Applicable Name:wA Name.MA Address:wA Address: wA City State: City: NIA State: Zip: Phone ZIP: Phone: FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x Not Applicable Name:wA Name:wA Address:wA 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 Coun#y 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 Horne 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,l 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 T JOB SITE BEFORE WE FIRST INSPECTION. IF YOU INT TO OBTAIN FINANCING, CONSULT 1'WrM YOU ER OR AN ATT ORE RECORDING YOUR NQ F CO CEMENT:' A�/ Signat r f Owner/Lessee/Contractor as Agent for Owner ti—griatudz1b6f Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 6RowARo COUNTY OF smwARo The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this =s day of JANUARY 2Q_20 by this 18 day of JANUARY 2021 by Name of person making s atement. Name of person making statement. Personally Known P o c d d ti i ''o Personally Known r OR Produced Identification Type of identification NoWy Pubsc Sty of ftaidz Type of Identification Produced Diane F Gsitinom" Produced iMy Commisslwi GG 2WN * Diane E G TVSri of ROM*>j t ExpiteS OtJOlJ2!!23 r my ca nmWion ou 7761 0110MAZI ignature of Notary Public State of Florlda) (Signature of Notary Public-St ri Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 2/7119