HomeMy WebLinkAboutKassa Permit10132020ALL 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
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
3
I
Address: 2840 Eagles Nest Way Port St Lucie FL 34952
Legal Description: Eaqles Retreat at Savanna Club phase 2 Blk 62 Lot 32
Property Tax ID #: 3424-702-0151-000-9 Lot No. 32
Site Plan Name: Kassa Block No. 62
Project Name: Kassa
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Installation of a solar electric system.
i
CONSTRUCTION INFORMATION:
itiona wor to (e�er orme un er t is permit — check a app y:
F]
❑HVAC ! Gas Tank FlGas Piping _ Shutters Windows/Doors
_I
1-1 Electric ❑ Plumbing Sprinklers El Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
1-1 Building Height:
Cost of Construction: $ Utilities:Sewer Septic
OWNERAESSEE:
Name Lawrence Kassa
Address: 2840 Fagle,, Nest Ala
City: Port St Lucie state: FL
Zip Code: 34952 Fax:
Phone No. 415-944-0455
E -Mail: lmkassa(Zhotmail c am
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
�.V tti ! Rl"\%. E Vit.
Name: Frik F Del ;npy
Company: Climatic Solar Corte_
Address: 650 2nd Lane
City: Vern Reach State: FL
Zip Code: 32962 Fax: 772-567-45x53
Phone No. 772 567 3104
E -Mail: officeachmatica^lar com
State or County License: CVC 36671
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:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
rnmmanrinu wnrk nr rPrnrding vnur Notice of Commencement.
Rev. 1/9/2019
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this _day of , 20_ by
this day of , 20_ by
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)
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 1/9/2019
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:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: — Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as inoicateo.
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 thepermit 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 whEch 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender an attorney before
__L _- ✓`. �....,.. hI-+'— _f rnmmanramant � 1
l.Vll llllctlVlll Wvinvl t vun, vv. ..v.. �. �-.+•••••.-"--...----
V
Si nature of Q e / Lessee/ actor or Owner
siknature of Contra or/Li ns Ider
STATE OF FLORIDA
STATE OF FLORIDA
Indian River
COUNTY OF Indian River
COUNTY OF
The forgoing instillment was acknowledged before me
I4P
The forgoing instrument was acknowledged before me
day Ce t'CbPJ 20.Q) by
thist-5 day of 20ALQ by
this J3L of
Erik F DeLanev
Erik F DeLaney
Name of person making statement.
Name of person making statement.
Personally Known V OR Produced Identification
Personally Known V OR Produced Identification
Type of Identification
7y e of Identification
Produced
p. �B-.AMANDA S WARR
r used """" AMANDA S WA
PP ;
_�°•'' `
_ MY COMMISSION # GG14
= My COMMISSION # G
063 .n•A<<;
<-
EXPIRES October 08, 20
1 / '? d� EXPIRES October 0
nature of Nota Public- St 5te of Floi id.
( ignature of Not uM c- State of fl r-
Commission No. GG149063 (Seal)
Commission No. GC' 14A063 (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
—
_
DATE
COMPLETED
Kev. l/y/Zuly
i � ,
Y ,.
_ ii,_ i �.