HomeMy WebLinkAboutSavagePermitPacketAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I- 5- 00a l Permit !Number:
:COUNTY
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Building Permit Application
Commercial Residential
PERMIT TYPE: Q ?oo�_S S}�
j PROPOSED IMPROVEMENT LOCATION:
Address:
Property Tax ID #: 3SD�_�LV) ( 00 i OOO 3 Lot Na -- f $ ^—
Site Plan Name: �C-kor►'CGS 5a\Ja 'r_' Block No.
Project Name: : q,nNc& Sctyq
DETAILED DESCRIPTION OF WORK:
Paa 1 ems.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
Mechanical
_ Electric
_ Gas Tank
Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 6 5
OWNERAESSEE:
Name ..c;rnLS Sa\1A
—Gas Piping
— Sprinklers
Address:)30(_) (� e � L C1 r c, c k o(L
_ Shutters — Windows/Doors
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: _ Sewer ` Septic Building Height:
City: ai(% ST C.,yc, ,, _ State:Ef
Zip Code: 3L(9 %--&- Fax:
Phone No.--? Z a q( lk Lf 353
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: b e, f _Zrti3 9clic
S
Company: 4Qa/ (5,nf_r-
Address: t�b s'-Ivt t lt'XCZI /4
City: T- i f11 C►'C--C State. F(
Zip Code: q 9 r(p Fax .'_1 1 -_)-q (c (P 1931
Phone No
E-Mail�[So gYC✓1 ��,94�� Ri 1, C,Urr
State or County License G_5(0
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:
DESIGN
NGIINEER: _-__ Not Applicable
Name,
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
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 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
--- I/,- �' Z' J��. ) I
Signature of Owner/ Lessee n ractor as gent for Owner
- -�
� �� i
Signature of Cont r/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST L ULI -,, I COUNTY OF 5T L UCG_ 1 r,
The forgoing instrument was acknowledged before me
this r day of.2 n uq{y 20.;Lj by
Name of person making statement.
OR Produced Identification
Type of Identification
Produced
(Signature of Notary ubli - State of Flori
Commission No. GG 4 ya�(Seal)
The forgoing instrument was acknowledged before me
this.ZdayofTgnOO-r 20o?f by
bt�y- + 1. I l r is
Name of person making statement.
ly Know OR Produced Identification
Produced
(Signature of Nota P lic-State of FWIda )
Commission No. (Seal)
REVIEWSMCR
"_Jf��VIE
OR PLANS VEGET 'Sf �e
REVIEW REVI aDATE
RECEIVED
DATE
COMPLETED
REVI
SOLARENEf GY SYSTEMS
An Energy
ESTIMATE and PROPOSAL
Management Company
0 160 Smallwood Ave.
Florida State Certified Solar Contractor #CV C056637
Ft. Pierce, Florida 34982
Martin Co.
Indian River Go. State
464-2663
288-0442
562-8999 1-800-330-7657
DATE
20
NAME
PHCN 777S4-1
Q
GJ7
L
f
E-MAIL
tiZ2r
C!_
ADDRESS
CITY
STATE
ZIPCODE
REF#
_� ( i ) �-#. , - -� r � ,t-, i It
`` c
Z tQ 5
SPECIFICATIONS: Solar Energy Systems offers to furnish and install; 0 SOLAR HOT WATER 0 SOLAR POOUSPA HEATING
0 HEAT PUMP
0 GAS HEATER
SOLAR WATER HEATING SYSTEM
SOLAR POOLISDPWakTING SYSTEM
I:) #—" —Collectors 4 x 8
4 x 10.5
4.x-� $
0 Heat Pump
$
0# Collectors
X
� Manual 3 Way valve
$
CI # Tank Size
Serial #
_ _ Q Automatic Control
$
O Pump Type _
Q Pool Blanket (x) _
$
O Over 60 Foot Run
O Pool Blanket Roller
$
Q Tilt
-
- 0 Additional Piping Over W
O Roof Type
0 Replacement Pump (HP)
$
0 2 Story
O Trenching
_ $
O 2 Tank Tie In
— 0 Spa Tie-in _
$
O 10 Year Warranty
a' Roof Type
$
O Pump HP
_ $
TOTAL $_
TOTAL$
PUMP INFO
�� �
�•
�
SPECIAL INSTRUCTIONS
Load Center
~4 � —��
l
_ � • - ` � ° r � I
Type
Breaker Req. A
Wire Gauge A
`1
Distance
i1J, ter
)
I f r tit
�--
tPServiCe—i(-V11-
220 Service
tl
Needed
"POOL BLANKET
Slab Needed
Legal Description:
- -- ----- -.'�
REQUIRED
FOA OPTIMAL
Service to be supplied by owner
Parcel - ID #
-
PERFORMANCE"
Yes No
LOT
INDICATESOLrrH
13LK SUB.
APPROVED BY
INSTALLATION
DATE
I understand that this is only an estimated date, and that I will be contacted prior to this date to
Submitted By:
schedule actual installation.
Customer Can euyAtThis Pnce Until,
Building / Pool
Phone #
(DATE)
Contractor:
We hereby propose to furnish labor & Materials - Complete installation to existing premises in accordance with above specifications, for the sum of:
TOTAL,
--DOLLARS $ -
With payments to be made as follows @ DEPOSIT $ - . , _ 0 BALANCE $__ Q UPON COMPLETION CI TO BE FINANCED
All system components (neat FSEC standards. All Work is to be completed in a workmarltika manner according to standard practices. Any alteratlon or deviation from above specifications InvoNing extra
costs, wiil be exectrted only upon written orders, and will become an extra charge over aN above the estlmate. All agreements are contingent upon strikes, w4dents or delays beyond lour oentrot.
The above prices, specifications and conditions are hereby accepted You are authorized to do the work as speciiled. Payment will be made as outlined above.
Payments not made upon completion subject to late fees after 10 days. Se a cancallatlon agreement on back of page.
DATE
S SIGNA
CArll ICS='C C1r,I11AT1 IM
MEMesn FILMNA
` CUSTOMER: WHITE OFFICE. PINK INSTALLER: MANILLA �FU0A
S�PA„.,.