HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED !^�
Date: Permit Number:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 5411 SILVER OAK DR
Property Tax ID #: 3402-607-0252.000.7
Site Plan Name: INDIAN RIVER ESTATES
Project Name: HAARER PV SYSTEM
DETAILED DESCRIPTION OF WORK:
RECEIVED
DEC o 0 7.019
Building Permit Application Renn(h(n91)eparhnent
St. LnC(e County.
Commercial Residential x
INSTALLATION OF GRID -TIED PV SYSTEM
CONSTRUCTION INFORMATION:
Lot No. _30 and 31
Block No. ; 22
Additional work to be performed under this permit— check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
X Electric _Plumbing _Sprinklers
Total Sq. Ft of Construction:
Generator Roof Pitch
Sq. Ft. of First Floor:
Cost of Construction: $ , 62,705.88 Utilities: -Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name DONNA E HAARER
Name: NEAL BURDICK
Address _5411 SILVER OAK DR
City: FORT PIERCE State: FL
Zip Code: 34982 Fax:
Phone No. (407) 949.1023
Company: WINDMAR HOME FLORIDA, INC.
Address: 7575 KINGSPOINTE PARKWAY SUITE 11
City: ORLANDO State: FL
Zip Code: stets Fax: (407) 502-7055
Phone No (4n7) sos.aoss
E-Mail:-cj.haaror@gmall.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mall NEAL BURDICK(aIWINDMARHOME.COM
State or County License E00002179
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: _ Not Applicable
Name: MIGUEL A ALVAREZ VELEZ
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address: 7575 KINGSPOINTE PARKWAY SUITE 11
City: ORLANDO State: FL
Zip: 32819 Phone (407) 308.0099
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 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
WIft YOURXENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
1
` I 'w' %I /la
ignature caner/ Lessee on ractor as Agent for Owner
Signature.of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF SAINT LI1cIE
COUNTY OF SAINT LUCIE
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 12T day of_ DECEMBER� 2015_ by
this 12THday of DECEMBER . 201.q-, by
CHAD ROGERS as POA for DONNA E HAARER
NEAL BURDCIK
Name of person making statement.
Name of person making statement.
Personally Known X OR Produced Identif' 1%ion
Personally Known X OR Produced Identification
Type of Identification r r i
A c4
Type of Identification x\\'NICA 61
�
Produced ��`�eONIC
Produced 'X to 0 T
an
Signature of Notary Public- State ofridah 2 —_
i nature of Notary Public- State of Florid a3 a A ��
Commission No. GG212960 (eaV IC
Commission No. GG212960 (SE;ie GBCIC
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