HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ,! Permit Number:
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Building Permit Applicati0 3 2020
Planning and DevelopmentServices
Building and Code Regulation Division unty, Permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 1382 NETTLES BLVD
Property Tax ID#: 4502-501-1569-000-4 Lot No. 1382
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
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: CONTRACTOR:
Name Joel M Hoose(LF EST) Name:EDWARD D.FLACK
Address:14154 Iroquois Woods DR Company:KILOWATT ELECTRIC COMPANY
City: Fenton State: MI Address:1700 NW 22ND AVE
Zip Code: 48430-1640 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 C(jNSTRUCT{ON;L`IEIV LAW X NotItV,FORMATION�
...�. ,. . ..._. � ._ .., .. .
DESIGNER/ENGINEER: _ Applicable MORTGAGE COMPANY: x Not Applicable
Name:wA Name:wA
Address:NA Address: wA
City State: City: wA State
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: !_Not Applicable
Name:wA Name:wA
Address:NIA Address.21A
City:WA 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 21 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 prahlbit 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 pians,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 THE FIRST INSPECTION. IF YOU INTfiND TO OBTAIN FINANCING, CONSULT
WITH YOU ER OR AN ATT EEORE RECORDING YOUR N0MCE,OF CO NCEMENT.07
signal r f owner/Lessee/Contractor as Agent for Owner Signat of Contractor/License Halder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF aaowmto COUNTY OF sigmAw
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this is day of JANUARY .2Q._20 by this 9s day of JANUARY .26 20 by
Name of person making statement. Name of person making statement.
Personally Known P o c d d ti i o Personally known Y OR Produced Identification
Type of identification Nay Pubft ROB�P>otlda Type of Identification
Produced Gsruun Ouse Produced
My Coo ML-Abn G0 2W88 a4.01 I NDmry Pt+bIN6 St10s o!Fiori
Fes=Ott010" t `� Diane E�d�°
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ignature of Notary Public-State of Florida) (Signature of Notary Public-St r
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
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