HomeMy WebLinkAboutDeribin Permit Applic 2All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Residential x
PERMIT APPLICATION FOR:
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PROPOSED IMPROVEMENT IQCATlON. <, 4 "A' r!/i/ , ,
Address: 209 Ramie Ln Port St Lucie, FL 34952
Property Tax ID #: 3419-515-0105-000-2 Lot No. 15
Site Plan Name: Block No. 23
Project Name: Michael P Deribin
DETAILED DESCRIPTIbN;n
Roof top solar photovoltaic electrical system connection to house
New Electrical Meter Second Electrical Meter
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:
Cost of Construction: $ 1,000.00
Windows/Doors _ Pond
Roof
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
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NameMichael P Deribin Name: Edgar Pons
Address:209 Ramie Ln Company: Edgar Electric Service INC.
City: 209 Ramie Ln State: _ Address:4208 26 Street SW
Zip Code: 34952 Fax: City: Lehigh Acres State: FL
Phone No. 954-789-9092 Zip Code: 33976 Fax:
E-Mail:Permits@bigorangesolar.com Phone No954-789-9092
Fill in fee simple Title Holder on next page ( if different E -Mail Permits@bigorangesolar.com
from the Owner listed above) State or County License EC13007968
Pitch
It value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTIQN LIEN LAVH, INFORMATIONIi ` %';%',
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DESIGNER/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:
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.
Lucounty and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
witr Lbnder or an attornev before commencing work or recording your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Contractor/License Holder
STATE OF FLORIQ.f4=C� STATE OF FLO A
COUNTY OF S COUNTY OF u}QS�''�
Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of
thisPhysical Presence or Online Notarization Physical Presence Rr Online Notarization
day of 2020 by this day of f l4 2020 by
W op `L" J -d QQa s
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known t_ OR Produced Identification
Type of Identificatio Type of Identification
Produced 0-D 1, Proyuced
S e of Notary P99�
(Sf ri e of Nota ^P 1
State of Florida��II rmo Teson, Commission No.
o m Sion No. GG 211103/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION
COUNTER I REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
`NtUrY Public Slafe of Florida
Alejandro Guillermo Tesone
F My Commissio4l';?9W ) 1183
—Expires 04/25/2022
SEA TURTLE I MANGROVE
REVIEW REVIEW