HomeMy WebLinkAboutApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
J- -` I.
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OWN
Planning and Development Services
Permit Number:
Building Permit Application
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:Ivelisse Quintero
PROPOSED IMPROVEMENT LOCATION:
Address: tSbUbl Lobblestone DR Fort Pierce, FL 34945
Property Tax I D #: 3424-702-0151-000-9
Site Plan Name:
Project Name: Ivelisse Quintero
DETAILED DESCRIPTION OF WORK:
n of photo voltaic solar panels on roof.
New Electrical Meter Second Electrical Meter
[CiONSTRUCTION INFORMATION:
Additional work to be performed under this permit– check all that apply:
Residential X
Lot No. 85
Block No.
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers _ Generator — Roof Pitch
Total Sq. Ft of Construction:
Cost of construction: $ 30,450.00
OWNER/LESSEE:
R
Sq. Ft. of First Floor:
Utilities: —Sewer _ Septic Building Height:
Address: 8509 Cobblestone DR Fort Pierce, FL 34945
city: Fort Pierce State: FL
Zip Code: 34945 Fax:
Phone No. 321 247 6073
E -Mail: flpermits@momentumsolar.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: Cameron Christensen
company: Momentum Solar
Address: 6001 Hiatus Road # 3 Tamarac, FL 33321
city: Tamarac State: FL
Zip Code: 33321 Fax:
Phone No 321 247 6073
E -Mail flpermlts@momentumsolar.com
State or County License CVC57036
If 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 CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: Mina A. Maker
MORTGAGE COMPANY: X Not Applicable
Name:
Address: 61 WINDLING WOOD DR APT 8B
Address:
City: Sayreville State: NJ
City: State:
Zip: 08872 Phone 551 589 5068
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
BONDING COMPANY: X 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.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attornev before commencine work or recnrdinp vnur NntirP of rnmmPnrPmPnr
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Signature of Ow er/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF St Lucie
COUNTY OF St Lucie
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 Physical Presence or Online Notarization
this 18th day of November 2020 by
this 18th day of November 2020 by
Ivelisse Quintero
Cameron Christensen
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification X
Personally Known X OR Produced Identification
Type of Identification
Type of Identification
Prod DL I
Prod d
(Signature of Notary Public- St
(Signature of Notary Public-
ori
�or►� CHRISTINA FAIRLESS
(18'b0WMISSION #GG975179
Commission No. GG975179
Commission No. GG975179
tirsY..�` , .IS71NA FAIRLESS
o MY SIGN #GG975179
01, 2024
EXPIRES: APR 01, 2024
APR
0eflded through 1 at state Insurance
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