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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: L• Permit Number:,"?ffz; ©© Is .:;, _fir_j. =� FFEB EIVED — o p - 3 2020 Building Permit ApplicationPlanning and Development Services . uceounty, Permitting Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x PERMIT TYPE:electric PROPOSED IMPROVEMENT LOCATION: Address: 164 NETTLES BLVD Property Tax ID#: 4502-501-0350-000-9 Lot No. 164 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: OWNERAESSEE: CONTRACTOR: Name Jeffrey A Rich Name:EDWARD D. FLACK Address:392 Bond Spring RD Company:KILOWATT ELECTRIC COMPANY City: West Newfield State: ME Address:1700 NW 22ND AVE Zip Code: 04095-3222 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 EC 13001961 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 CO"UC oWt,l'EN LAW INFORMAT)O, - DESIGN ER/ENGI NEER: DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable Name:NIA Name:N/A Address:N1A Address: N1A City State: City: NIA _ State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x Not Applicable Name:NIA Name,NIA r` Address:NIA Address: NA City:NIA City:NIA Zip: Phone; Zip: Phone: OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and Installatlon as indicated. I certify that no work or installation has commenced prior to the issuance of a permit. St.Lucie Count makes no representation that is granting a permit will authorize thedpermit holder to build the subject structure which is in conflict with any applicable Home Owners Assoaation rules,bylaws:or an 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 JUE,JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTW TO OBTAIN FINANCING, CONSULT WITH YOU ER JR AN ATTCRNEXJ3EF.ORE RECORDING YOUR NOTICOF CO CEMENT." lxole Signat r f Owner/Lessee/Contractor as Agent for Owner SlgnatuEerof Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF BHowARo COUNTY OF BRowAm The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 16 day of JANUARY .20 2a by this 16 day of JANUARY ----2020 by Name of person making statement. Name of person making tatement. Personally Known P o c d d ti i o Personally Known OA Produced Identification Type of Identification . Type of Identification .V Notuy Pub&c Stats of FWM Produced Cingt1Ruse Produced my cwm*4;�GO 2ff" fat► u� NOrary Pu4Re$tats of Pbri 01/01=23 r `h Mne E Owlingho Q My Com tuim 2577611 lift a ens dkAftWAVQA ~his,IV ) E,�phes alffil t123 ignature of Notary Public-State of Florida) (Signature of Notary Public-St n 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.