HomeMy WebLinkAboutAPPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
L'LCI F \-
ff L a, r:, ° L `:' - ~�- Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 6804 WADSWORTH TER PORT ST LUCIE FL 34952
Property Tax ID #: 3415-705-0036-000-8 Lot No. 35
Site Plan Name: Block No. 1
Project Name: PV HENDRICKS
DETAILED DESCRIPTION OF WORK:
INSTALLING A ROOF MOUNTED SOLAR PHOTOVOTLAIC SYSTEM
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit– check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 40,000 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameJOHN HENDRICKS
Na me: DANIEL YATES
Address: 6804 WADSWORTH TERRACE
Company: EFFICIEN THOME SERVICES OF FLORIDA
City: PORT SAINT LUCIE State: _
Zip Code: 34952 Fax:
Phone No. (423) 258-4439
Address: 9416 INTERNATIONAL CT N
City: ST PETERSBURG State: FL
Zip Code: 33716 Fax:
Phone N0844-778-8810
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail PERMITTING 9EHSFL.COM
State or County License EC13008759
it vawe or construction is t5uu or more, a KtCUKDtD Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name: REYES RUIZ-DONATE
MORTGAGE COMPANY: x Not Applicable
Name:
Address: 9416 INTERNATIONAL CT N
Address:
City: STPETERSBRUG State: FL
Zip: 33716 Phone844-778-8810Zip:
City: State:
Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:
BONDING COMPANY: X 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing work or recording our Notice of Commencement.
ev. J/O/Lu
Sign atur o ont actor/License Holder
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OFSAINTLUCIE
COUNTY OFPINELLAS
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
X Physical Presence or Online Notarization
X Presence or Online Notarization
this W day of JULY 2020 by
^P.h-�siCal
thi s fL day of JULY 2020 by
JOHN HENDRICKS
DANIEL YATES
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification xxx
Personally Known xxx OR Produced Identification
Type of Identification
Type of Identification
Pr ced
oducecl
(Sigriatdre of Notary Public- Sta a of Florida
(Sight re of Notary Public- S to of Florida
Commission No. GG249046 (Seal)
Commission No. GG249046 (Seal)
REVIEWS
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MANGROVE
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DATE
RECEIVED
DATE
COMPLETED
ev. J/O/Lu