HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
PERMIT TYPE: Solar
P O o C 1NRRC V 'MENT .. .. ..
L.. ...... A" 1:
Permit Number:
Building Permit Application
Commercial Residential X
Address: 10725 S Ocean Drive Jensen Beach, FL 34957
Property Tax ID # : 4511-502-0102-00-7
Project Name: Dubois
Installation of a solar electric system
Lot No. 14
C TRUCT I N RMAT N
.......... .
Utilities: Sewer Septic Sq. Ft. of First Floor:
Cost of Construction: $
Name Mariella Dubois
Address: 8652 Tourmaine Blvd
City. Boyton Beach State:
Zip Code: 33472 Fax:
Phone No.
Total Sq. Ft of Construction:
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: Erik F. DeLaney
Company: Climatic Solar Corporation
Address: 650 2nd Lane
City: Vero Beach State: FL
Zip Code. 32962 Fax: 772-567-4553
Phone No 772-567-3104
E-Mail-office@climaticsolar.com
State or County License CVC56671
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENT _ CNTTONU T10,�. .
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DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: Not APp licable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE MOLDER: Not Applicable
BONDING COMPANY: Not Applicable
Name:
Narrie:
Address:
Address:
City:
City° - - -----
Zip: Phone:
Lip: 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 twig for
I
mprovements to your property. A Notice of Commencement must be recorded 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 rear ing your Notice Commencement.
Signature of Owner/ Lessee/Contractor as ►ge #-or owner Signature of Cont�a6tor/Lice Voldtir�
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Indian River COUNTY OF Indian River
The forgoing instrument was acknowledged before me The forgoing instr ment was acknowledged before me
this day of Vk 20 `� by this day of V4 ✓& 20 ` } by
Erik F. DeLanev Erik F. DeLaney
Name of person making statement. Name of person making statement.
Personally Known �- Personally Known OR Produced Identification
Type of Identificatio _°rGtih Ya "c�� AMANDA S WARREN Type of Identification .;��+�r
Produced _� r Produced :.sQ�'•`'v' AMANDA � ��� - �N
MISSION 4 GG14900., -
08
021
,- •o��'' EXPIRES October 48, 2021 MY C�7MMIS��,�;�1
�j EXPIRES October
(Signature of Notary Public- State of Florida )
Commission No. GG 149063 (Seal)
REVIEWS I FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED_
DATE
COMPLETED
ev.
signature of Notary Public- State of Florida )
Commission No. GG 149063 (Seal)
SUPERVISOR I PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW I REVIEW REVIEW REVIEW