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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �-�� �C� Permit Number: 2O oa' Building Permit Application o 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 X PERMITTYPE: ELECTRICAL PROPOSED IMPROVEMENT LOCATION: Address: 1269 NETTLES BLVD Property Tax ID#: 4502-501-1456-000-9 Lot No.1269 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 Timothy C Wright Name:EDWARD D.FLACK i Address:705 Verbenia Dr Company:KILOWATT ELECTRIC COMPANY City: Satellite Beach State: FL Address:1700 NW 22ND AVE Zip Code: 32937-2534 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 CONMI LI TiON',LIEN LAW IN.F©AMVl tli7N ? DESIGNER/ENGINEER:; x Not Applicable MORTGAGE COMPANY: x Not Applicable Name:NIA I Name:fuA Address:NA Address: NIA City State: City: NIA 'State• Zip: Phone Zip: Phone: —71 FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x Not Applicable .I Name:NIA Name,NIA Address:wA Address, NIA City:NIA City:NIA Zip: Phone: Zip: Phone: OWNER/CONTRACTOR AFFIDVIIT: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 County makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in conIct with any applicable Horne Owners Association rules,bylaws or and covenants that may restrict or pro rbf#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, i accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use i, "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROYEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON T JOB SITE BEFORE THE FIRST INSPECTM. IF YOU I TO OBTAIN FINANCING, CONSULT Willm YOU ERR 00 AN ATT EF.ORE RECORDING YOUR NO F CO CFMFNT." Signat r f owner/Lessee/Contractor as Agent for Owner Signat of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF eaowARo COUNTY OF wzowAw The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this Is day of JAfduARY ,20 20 by this is day of JANUARY 2021_ by Name of person making statement, Name of person makin/g�tatement. ! Persontt P o c d d ti i t'o Personally Known r OR Produced Identification Type oype of identification !i NAY�" °4 FloridaPforida Produced Produced Gariinghouse y> Notary Public Shoisoffbd My Comr�issio Gia 2f3"8111 r t> r otmtrt023 Diane E=W$"�0 �/VCMMr �( 7gnaState 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 i DATE RECEIVED DATE COMPLETED Rev. 2/7/19I l i