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Building Permit Application
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /�1�� Date: �j -�•7� Permit Number: tin. ® 1`39 RMuvgD Building Permit Application LST- Lucie AR 0 5 2020 Planning and Development Services Building and Code Regulation Division County, Permitting 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X PERMIT TYPE:ELECTRICAL PR©POSED IMPROVEMENT LQCATION; Address: 353 NETTLES BLVD Property Tax ID#: 4502-501-0539-000-8 Lot No.353 Site Plan Name: Block No. Project Name: 7777777 DE'AILED DESCRIPTION OF WORK 3 �. .. Install a new 20 amp 120 volt receptacle in new customer supplied enclosure plus/minus 5ft.from the existing power supply rr .CONSTRUCTI( fV INFORMATION f,�' E s , a e..., ..4 ,. 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 ; ryrCONTRACTOR s Name Gerald W Bashant Sr(TR) Name:EDWARD D. FLACK Address:540 SW Akron AVE Company:KILOWATT ELECTRIC COMPANY City: Stuart State: FL Address: 1700 NW 22ND AVE Zip Code: 34994-2912 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. 5 %E�+ITAL Ct�NSTR (]N I_ G ~DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable Name:NIA Name:N/A Address:NIA Address: N/A City: State: City: N/A State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x Not Applicable Name:wA Name:NIA Address:N/A Address: NIA City:N/A City:N/A 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 thepermit 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 WITH YOU ER QR AN ATT RECORDING YOUR NO)RCUFCO CEMENT." Signat r f Owner/Lessee/Contractor as Agent for Owner Signatufelof Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF BRowARD COUNTY OF sRowARD The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 16 day of JANUARY 202o by this 16 day of JANUARY .2020 by Name of person making s atement. Name of person making atement. Personally Known P o c d ti ' 'oOWWs Personally Known OR Produced Identification Type of Identification Type of Identification iarWa Produced N0� �h0Pubftstw 0f�F8 Produced64 + MY Came ion Gt3 287788 d NctM Public State of a 81 Expireb Otrotr2029 r ;� Diane E Garfnghouse A0%ar Carty �01101MMMy Commissiwt 2877 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 CO2/7/19 MPLETED ev.