HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 202 02• J-'nip Permit Number: 0
FEUMLEIVED
Building Permit Application FEB 5 2020
Planning and Development Services I 'rmitting Department
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 / St. LUCIe County, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial s+4enial
PERMITTYPE: EleC+ri C.
PROPOSED IMPROVEMENT LOCATION:
Address: 122 DUSK WAY FORT PIERCE, FL 34945
Property Tax ID#:2308-Coo l - 0\(a2-000-o1 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
INSTALLATION OF SOLAR PHOTOVOLTAIC SYSTEM
CONSTRUCTION INFORMATION: -. . _
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
X Electric _ Plumbing _Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: `-0 Sq. Ft. of First Floor: 11990
Cost of Construction: $2(vl7`k0•DO Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: -
CONTRACTOR: '
Name N� Uo,-fou\icon I11
Name:PhiliP'Ro'kLtL-)
Company: Pc\tech @lec-Voc.oi Urrhral Fl,t Inr.
Address: 122 DUSIr_ \Nay
City: `For-1- -pie.rce State:_
Zip Code: ')401 `I C� Fax:
Phone No.(-7 7 z) 5 Sq - (v 12ID
Address:-722LA Chrnrye.n4Ln.
City: 0(-\oAr,c10 State:
Zip Code: 3213 09 Fax:
Phone No No-1)951--la-19
E-Mail:he,rir&A. 10,�ouyylrc in j2�A0.h� oo CrjM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail Derrn� a 0,1 -CGh 2\2drri c,• Co m
State or County License 'EC 13o0I U $ 2-
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 CONSTRUCTION LIEN LAW
INFORMATION:'
DESIGNER/ENGINEER:
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:
Address:
City:
City:
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 conl lict 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 J B SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOU i AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
ignatu Owner/ Lessee/Contractor as Agent for Owner
1.5',at f-Contracto /Licen elder
STATE OF FLORI A
STATE OF FLORIDA
COUNTY OF �'r Lao—
COUNTY OF : t ( _U, Vv
The forgoing instru{nent was acknowledged before me
The forgoing instrument was acknowledged before me
this day of Jn+� 20 Ja by
this � day of Win.* 20 p by
Lr as Ls nd-aln 1
1 n 1 ��(/
Name o erson making statement.
Name of p rson making statement.
Personally Known OR Produced Identification
Personally Known —4 OR Produced Identification
Type of Ideritification
Type of Identification
Produced i\2fS LaAw-
Produced
nature of N 1
re of Notary Pu
Notery Pubbe State at FWr da
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Commission N '�
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Commission No. Jesan �i113f
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VEGETATION
SEA TURTLE
MANGROVE
COUNTER
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COMPLETED
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