HomeMy WebLinkAboutHawkinsPVPermitPacketAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7 ' a'lo� Q Permit Number:
Building Permit Application
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
PERMIT TYPE: `x iCa
PROPOSED IMPROVEMENT LOCATION:
Address:
Property Tax ID #:
Site Plan Name: _
Project Name:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
Mechanical _ Gas Tank _ Gas Piping Shutters
_ Electric __.. Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ -24 Utilities: _Sewer _Septic
OWNER/LESSEE:
Name Cti t`
City: F'i 0ie.'rC.t. _ Stater
Zip Code: �'J '� 4 !� Fax:
Phone No.—)
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
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Lot No.
Block No.
Windows/Doors
_ Roof Pitch
Building Height:
CONTRACTOR:
Name:
Company: ui4(- E4)r—f S
Address. { J 06 d
City: �U�A V % e. r C v— State:
zip Code: 3`-Iq`cs� Fax:1-014� )93-�
Phone No—1 11'ha'} QJ-P �o3 _
E_-Mail u �l
State or County License 0 Itr (V (0
If value of construction its $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:
l
DE5IGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address. Address:
City: City:
Zip: Phone: Zip: Phone:
E _ _
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 structurewhich is in convict 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/ /Con ractor as Agent for Owner
Signature of Conk r License Holder
STATE OF FLORIDA,
COUNTY OF
STATE OF FLORIDA -
�u Cates
COUNTY OF I
The forgoing instry11�ent was acknowledged before me
i
The forgoing instrument was acknowledged before me
this day of Jy(%t 2QcS�L by
this day of. Jv0 G , 20__ by
J
T1��,lPrkl _Z_1!'C.1.�
-
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Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of identification
Type of identification
Produced
Produced
(Signature of Notary Public- State of Florida J
(Signature of Notary Public- State of Florida )
commission No. (Seal)
Commission No. (Seal)
N
�7
ry Public State of
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Kimberry Large
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501.RR ENERGY SYSTEMS ESTIMATE_ and PROPOSAL��
An Energy Management Company
_ _
0 160 Smallwood Ave. Florida State Certified Solar Contractor #CV C056637
Ft. Pierce, Florida 34982 Martin Go. Indian River Co. State
DATE_ 20 ,
464-2663 288-0442 562 8999 1-900-330-7657 .____
NAME NPHONE OFFICE
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HA „ ,VLf.
ADDRESS CCITYSTATE ZIPCODE REF#
7 4
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SPECIFICATIONS: Solar Energy Systems offers to furnish and install: O BACK-UP GENERATOR
-1 SOLAR ELECTRIC SYSTEM
!I Grid -Tie -le �Wbaslt tip 0 Stand Alone
ELECTRICAL INFO +
System Size KW
Location of Breaker Panel
Model # of Breakers -
# of Empty Slots Available L G: _
AC Requirements: l 120 V 0 240 U SAI PH
Array bunt Type: P Flush CI Tilt k
Distance to Solar Array _-_ � Ft_
Roof Type: 0 Shingle 0 Flat Tile B ,,.._
� Gedetr'Shake Q Metal 0 *r t' �"
Clear Attic Access: 1 Yes 17 No
'I Single Story 0 2 Story 0 Lift Required
Name of Utility Company:
N ES:
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BACK-UP INFO IF APPLICABLE
' i !'t irtpljCt :a
# of days of Back-up Requested
Sketch of Roof Area
Battery Type: 03 1=laode eared
Battery Rack abinet Q
Legal Description: Parcel - ID #
LOT BLK SUB.
Batt ocation: 0 Outdoor 0 Indoor
INSTAI.LATION �1 ► I understand that this is only an estimated date, and
DATE - f 1 7 r ule actual installation.
that I will be contacted prior to this date to Schad-
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Custamar Can Huy At This Price (told. (D E
Building Contact:
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Contractor:
We hereby propose to furnish labor& materiqLqzLamplete Insjtallati n to existing promises in acc�odda to spec) . all ns, for a sum oof.
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TOTAL _ D _
With payments to be Joe as follow DEPOSIT $ ° - '�" M BALANCE $L_�'.._ .._ O UPON COMPLETION PTOBEFINANCED
All system components most FSEC standards. All work Is to be compteted in a workmanlike manner according to standard practices. Any aHeration or deviation from above specifications Involving extra costs,
will be executed only upon written orders, and will become an extra charge over and above the estimate. All agreements are contingent upon strikes, accidents or delays beyond our control.
The above prices, specifications and conditions are hereby accepted. You are authorized to do the work as spec'Ifled- Payment will be made as outlined above.
Payments not• made ILdpon completion subject to late fees after 10 days. See cancellation agreement on back of page.
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BATE (CUSTOMER'S SIGNATURE) (SPOUSE'S SIGNATURE)
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CUSTOMER: WHITE OFFICE: FINK FPL PARTICIPATING INSTALLER: MAWILLA FLawmt
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SOLAR SYSTEM RETROFIT
PROJECT NAME: HAWKINS RESIDENCE
PROJECT ADDRESS: 257 BIMINI DR.
FORT PIERCE, fL 34949
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