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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: '(� 0 Permit Number: 2 CPR, R 0 6 ('Building Permit ApplicatioCounty, Permllulf'"_� 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 PERMIT TYPE: ELECTRICAL PROP©SED IMPROVEMENT LQCATI©IV r Address: 670 NETTLES BLVD Property Tax ID#: 4502-501-0856-000-6 Lot No.670 Site Plan Name: Block No. Project Name: DETAILED QESCFtIPTION C1F WORKx }z t Install a new 20 amp 120 volt receptacle in new customer supplied enclosure plus/minus 5ft.from the existing power supply r GQNSTRUCTIQN INF:ORMATI©N.h , ' 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: 01(1/NERJLES�SEa ., ;3 � ' 'CONTRACTfI R`. rrF'� Name Brian Colgan Name:EDWARD D. FLACK Address:670 Nettles BLVD Company:KILOWATT ELECTRIC COMPANY City: Jensen Beach State: FIL Address:1700 NW 22ND AVE Zip Code: 34957-3348 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. - Rw StJPP`LE�MENTAL CO'NSTR IO LIEN LAW I'N'FOR'MAti,ON: DESIGNER ENGINEER: x Not Applicable x / — Pp MORTGAGE COMPANY: Not Applicable Name:N/A Name:NIA Address:N/A 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:N/A Name:N/A Address:N/A Address: N/A 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 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 jjfEi JOB SITE BEFORE THE FIRST INSPECTION. IF YOU III TO OBTAIN FINANCING, CONSULT WITH YOU ER 9F AN AV=QRg4=@MqFE RECORDING YOUR NO F CO NCEMENT." Signat r f Owner/Lessee/Contractor as Agent for Owner Signatdre,of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF BROWARD COUNTY OF BROWARD The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 16 day of JANUARY ,20 20 by this 16 day of JANUARY 2020 by Name of person making statement. Name of person mak70R tatement. Personally Known P o c d ti i t'o Personally Known Produced Identification Type of Identification r NotMPubkStMeofFbrida Type of Identification Produced Gaftouww Produced a My Commission GG 287788 ow Notary Public State of Flo fro, Expires 01/01/2023 ;4 Diane E Gadinghouse M My Commission GG 28778 bra�d� Expires 01101/2023 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 ev.