HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �j Q(�
Date:"i(P�Q � W Permit Number:2, 03- lel 1 l l
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Building Permit Applicatio MAR 0 6 2020
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division 9
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMITTYPE: ELECTRICAL
PROPOSED §I IpRQVEWE` LOCATION
Address: 674 NETTLES BLVD
Property Tax ID#: 4502-501-0860-000-7 Lot No.674
Site Plan Name: Block No.
Project Name:
:DETA'ILED DrSCRIPTION t3F WORK
Install a new 20 amp 120 volt receptacle in new customer supplied enclosure plus/minus 5ft.from the existing power supply
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GONSTRUCThC1N INFCIRIVIATION_: .
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:
( WNER/LESSEE , CON RACT� R
Name Mario Aubin Name:EDWARD D. FLACK
Address:1271 Rue Moorecrest Company:KILOWATT ELECTRIC COMPANY
City: Mascouche State: QC Address:1700 NW 22ND AVE
Zip Code: J7L 1C2 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.
UPfi
;fUIiENTAL CON TRUCTiON LIEN LAIIIT I'NFORMATiON: '
DESIGNER/ENGINEER: x—Not Applicable MORTGAGE COMPANY: X Not Applicable
Name:N/A Name'NIA
Address:NIA Address: NIA
City: State: City: N/A State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: x Not Applicable
Name:NIA Name:NIA
Address:N/A Address: NIA
City:N/A 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 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 T JOB SITE BEFORE THE FIRST INSPECTION. IF YOU IM3W TO OBTAIN FINANCING, CONSULT
WITH YOU ER W AN ATT E RECORDING YOUR NO F CO NCEMENT."
Signat r f Owner/Lessee/Contractor as Agent for Owner Signat 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 76 day of JANUARY ___-.2020 by
Name of person making statement. Name of person making tatement.
Personally KnownP o c d ti i o Personally Known OR Produced Identification
Type of Identification
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Type of Identification
Produced N°taryPubkcState Produced
ne.E+ nghouse
My Comri� GO 287788 .fs Nosy Pub*c SGte of Flo
Expaes 0110112023 r ;4 Diane E Garfighouse
v My Commission GG 267791
AVA a,w Expires ovol a23
(Signature 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.