HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I a d Permit Number:
— -- - D-
' JAN 0 8 2020
Building Permit Applicati n
' ST. Lucie County, Permittinc
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
PERMITTYPE: SOLAR
PROPOSED IMPROVEMENT LOCATION:
,.,,,.e-... 8200 Fort Walton Ave
Property Tax ID #: 1301-606-0073-000-9 Lot No.
Site Plan Name: Block No.
Project Name: David Ogden Solar
.DETAILED DESCRIPT►fJN OF WORK ".. ... �a
Roof mounted PV Solar and electrical interconnection.
CONSTRUCTION INFORMATION, a r;.� :_' ? :
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
Total Sq. Ft of Construction: 5-13 • 3 Sq. Ft. of First Floor:
Cost of Construction: $ L4-1 , o Or., Utilities: —Sewer —Septic Building Height:
Pitch
OWNER/LESSEE;
CONTRACTOR:
Name Oavcd 004,e.tt
Name: Q(aourd Lor+go d'r_
Address: Klo o F=or-E A,%o p_
Company: Floc -I rfa Power Mann ae r�.(o a f-
City: Fort gw-rc 2 State: Fes-
Zip Code: 34g51 Fax:
PhoneNo. 1-12-- SSIt- Z-151
Address: I1s31 C%yQPn Foryct G4 . 0 3
City: Wrh"X Garde State: 4--I-
Zip Code: S41Q1 Fax:
Phone No 40l - GS4 - 2-04-1
E-Mail: o !ack" . Aa-v, A @
Fill In fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail�jnn o. La Ian cc .....
State or County License roc. 13 00 ti; GLl S
It 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 I AW'INFORMATION+ " -'-"-
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: — Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
Zip:
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 THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor.as Agent for Owner
.Signature a Contracto ce older
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF 0ICrn5l
The forgoing instrument was acknowledged before me
The for oing instr nt was acknowledged before me
this ._ day of .20_ by
this dayof�2013 by
R-
Name
Name of person making statement.
Name of person making stateYnent.
/
Personally Known OR Produced Identification
Personally Known OR Produced Identification V
Type of Identification
Tye of Identific lion DI,,
P du d
vigigure
(Signature of Notary Public -State of Florida)
of Notary Public-S ate f FI
Commission No. (Seal)
G� �.✓' Notary Public Sta
Commission No. -1 I Nicole Byington
g �+ My Commission G
ERpims 10ra1202
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
I
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.
SUPPLEMENTAL CONSTRUCTIOWLIEN LAW INFORMATION: `
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
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 Count makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in con 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 yourdeed 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 THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
L
Signature of Owner/Lessee/Contractor.as Agent for Owner
.Signature Contractor c Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF n" <�
COUNTY OFQ(Zange
The f r oing instrument was acknowledged before me
thisiEdayof 20_Wby
The f going instru was acknowledged before me
this: dayof 2020by
�aVi� �o�r
I
V�Ic�.aacY Len�6 Jla-
Narri person makings ement..
Name of person making st rement.
Personally Known OR Produced Identification _X_
Personally Known OR Produced Identification ie
Type of Identification
Type of Identification
Pro ced A..-
Pro ced L,
(I@qaot-a'rTP'Mic-tateof A
NotaryP lic-State
t+�.c .Y�• No ry u UcSateof
Commission No. �R 2� -r 1 (�e tole Byingt
Florida •N' Notary Public State
rcommission o. � 2 S �IlNicole Byington
10,27570 +� Ny Commiuion GG
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23
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.Z/7/19