HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
J - E=
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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 x
PERMIT TYPE: Solar
PROPOSED INPROVEMENT LOCATION:
Address: 2401 Tilton Road Port St Lucie, FL 34952
Property Tax ID #: 3414-501-1107-050-0 Lot No. 7
Project Name: Hampson
DETAILED DESCRIPTION OF WORK:
Installation of a solar pool heating system
CONSTRUCTION INFORMATION:
Utilities: _Sewer _Septic Sq. Ft. of First Floor:
Cost of Construction: $ 4,200 Total Sq. Ft of Construction:
FLOODPLAIN DEVELOPMENT PERMIT for structures exempt from Building Code that are in the
floodplain:
Nonresidential Farm Building: Temp. Bldg./Shed used exclusively for construction
Mobile/Modular for temp. construction office: Bldg. involved in distrib. of electricity:
Other: Flood Zone:_ BFE:_ Floodway? Y/N If Y,
No Rise Certificate with supporting data attached? Y/N
All other applicable state and federal permits shall be obtained prior to commencement of
construction.
OWNER/LESSEE:
CONTRACTOR:
Name Casey Hampson
Name: Erik F. DeLaney
Address: 2401 Tilton Rd
Company: Climatic Solar Corporation
City: Port St Lucie State: _
Zip Code: 34952 Fax:
Phone No. 305-481-8571
Address: 650 2nd Lane
City: Vero Beach State: FL
Zip Code: 32962 Fax: 772-567-4553
Phone No 772-567-3104
E-Mail: caseyadele26@gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
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 $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN"LAW INFORMATION _
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 Rome 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
cornmencing work orpe'corcling your Notice of Commencement.
L.9
Sig azure of Owner/ Lesse / tra or a Agent for Owner
Sign re of Contractor/Li a old r
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Indian River
COUNTY OF Indian River
The forgoing instrui e t wa5 ackn wledged before me
The forgoing instru_rngnt was c� knowledgeqbefore me
1� 11 J �i/Y by
this � day of 200� by
this day of , 20
Erik F. DeLanev
Erik F. DeLaney
Name of person making statement.
Name of person making statement.
%/ Produced Identification
Personally Known OR Produced Identification
Personally Known OR
Type of Identification
Type of Identification
Produced DA S WARREN
`O'
Produced
"o,. •
MY COMMISSION # GG149063
"�'
. o.• AMANDA S WARRE
" o EXPIRES October 08. 2021
= MY COMMISSION # GG149
6
(Signature o ota Public- S
(Signature of N u ic'!;f ' � ,6f FI c o er 2
Commission No. GG149063 (Seal)
Commission No. C,C149063 (Seal)
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