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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q Date: 2. Permit Number: RECEIV90 Building Permit Applicat on MAR 0 4 2020 Planning and Development Services ST. Lucie County, 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:ELECTRICAL {?ROl?05EDl11tlPRQVEMENT LQCATlt3N � � a� Address: 120 NETTLES BLVD Property Tax ID#: 4502-501-0306-000-6 Lot No.120 Site Plan Name: Block No. Project Name: C? 10 OCRCP1QETA1EEES R:' ' Install'a new 20 amp 120 volt receptacle in new customer supplied enclosure plus/minus 5ft.from the existing power supply 001, CQ(�STRl�CTION INI.ORMATI©N � Additional work to be performed under this permit–check all that apply: _Mechanical _Gas Tank —Gas Piping _Shutters _Windows/Doors RV( 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: z' 33n € td.nNs ;, wn�xwiti ✓3kr3„ Yom . rx {}WNEFt/I:ESSEE k x r C©ITRACTI�R va°x°.o.r Name William F Kern Name:EDWARD D. FLACK Address:306 Salt Marsh Ln Company:KILOWATT ELECTRIC COMPANY City: Groveland State: FL Address: 1700 NW 22ND AVE Zip Code: 34736-3639 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. CEN: DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable Name:NIA Name:NIA Address:N/A Address: NIA City: State: City: NIA State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x Not Applicable Name:NIA Name:N/A Address:N/A 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 County 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 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU TO OBTAIN FINANCING, CONSULT 4� WITH YOU ER OR AN TT E RECORDING YOUR NO F CO NCEMENT." S�ignat r f owner/Lessee/Contractor as Agent for Owner Signatufzlo'f Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF BROWARO COUNTY OF sRowAm The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 16 day of.JANUARY 20 20 by this 16day of JANUARY 202Q by Name of person making statement. Name of person makingfitatement. Personally Known R F o c d ti i Personally Known / OR Produced Identification Type of Identification Sto of Swida Type of Identification Produced -4-0 211k Remy rviano-F C-ad- 101 2r h NMiy Pubft StM a9l Fbio a my comniss� 3 :1 DianeE Gaffmhouse Eyphvws OVO I my Commis GG 28771 Ex0ires 01101/= 0% (Signature of Notary Public-State of Florida) (Signature of Notary Public-S r Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED T_ DATE COMPLETED Rev.217119