HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: 2.
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Building Permit Applicati®
Planning and Development Services FEB 04 2020
Building and Code Regulation Divisionpermitting
2300 Virginia Avenue,Fort Pierce FL 34982 ST. Lucie County,
Phone: (772)462-1553 Fax: (772)462-1578 Commercial, Residential
PERMITTYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 1383 NETTLES BLVD
Property Tax ID#: 4502-501-1570-000-4 Lot No.1383
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 Crown Rayal Enterprises LLC Name:EDWARD D.FLACK
Address:2015 SE Momingside BLVD Company:KILOWATT ELECTRIC COMPANY
City: Port St Lucie State: FL Address:1700 NW 22ND AVE
Zip Code: 34952 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.
SUPPI EMENTAL`CONSTRUCTIDN I.lE1V LAW.1NFClRiV(AT!(J(V;
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable
Name:wA Name:wA
Address:wA Address: wA
City State: City: wA —State:
Zip: Phone Zip: Phone-
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x Not Applicable
Name:wA Name:wA
Address:wA Address: wA
City:NA 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 con ict witt 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 THE)JOB SITE BEFORE THE FIRST INSPECTION. IF YOU IMT-W TO OBTAIN FINANCING, CONSULT
WITH YOU ER QJt AN ATT EF0JtE RECORDING YOUR NORtE41F CO CEMENT."
Signat r f Owner/Lessee/Contractor as Agent for Owner Signatuftelof Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF eRowARO COUNTY OF wmwARO
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 16 day of JANUARY 2020 by this1s day of JANUARy .2020 by
Name of person making statement. Name of person makingstatement.
Personally Known R P o c d d ti i t* Personally Known OR Produced Identification
Type of identification r Y Pubft State of Rollo Type of identification
Produced � Gattinghouse Produced40 pUM gyfta{fso
v ky Commiiail GO 2B77Ra �Stop O�te E(36rHtfgllouse
Eacpires fltm1t2o29 My L;arimWbn d 2677
ignature of Notary Public State of Florida} (Signature of Notary Public-St rz
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
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