HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: . 1 l Permit Number: v
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Building Permit Application APR 12 2017
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Planning and Development Services PERIMITTII�G
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: 6103 BALSAM DR FORT PIERCE FL 34982
Legal Description. INDIAN RIVER ESTATES-UNIT 09-BLK 87 LOT 33 (MAP 34/12S)(OR 3956-1200)
Property Tax ID#: 3402-610-0529-000-0 Lot No.33
Site Plan Name: 6103 Balsam DR Fort Pierce, FL 34982-3775 Block No. 87
Project Name: FITZNER MORIN SOLAR ELECTRIC SYSTEM
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
INSTALLATION OF A ROOFTOP SOLAR ELECTRIC SYSTEM COMPLETE WITH ALL
MOUNTING SYSTEMS, ELECTRICAL, INVERTER AND SOLAR PANELS. NO BATTERY BACK
UP AND NO STANDALONE OPERATION.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all apply:
E1HVAC Gas Tank Gas Piping Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers Generator �Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ 22275 Utilities:Sewer[]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name ROBERT FITZNER/ELIZABETH MORIN Name: JUSTIN HOYSRADT j
Address:6103 BALSAM DR Company: VINYASUN CORP.
City: FORT PIERCE State:FL Address: 313 DATURA STREET SUITE 101
Zip Code: 34982 Fax: City: WEST PALM BEACH State:FIL
Phone No.407-202-2440 Zip Code: 33401 Fax:
E-Mail:studebaker2460@6mail.com Phone No. 561-440-9537
Fill in fee simple Title Holder on next page(if different E-Mail: PERMITTING@VlNYASUN.COM
from the Owner listed above) State or County License: CVC56967
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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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:
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 wi lender or an attorney before
corrlikencing work of recording our Notice of Comm ncerrlent.
s
Si ature c 0 /Lessee/Agent Sig ure tractor/License Holder
ST TE OF I RIDA S ATE OFF ORID
UNTY OF S�' . ldlC tt UNTY OF . l.ticlt
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this It day of AGO r ►1 20 LI by this_L day of AlDr 1 20 jI by
_1 rµ►n 4-bM c r a A-t SuS+I,n t�S ra dt
(Name of person acknowledging) (Name of person acknowle ging)
(Signature of Notary Public-StAe of Florida) (Signature of Notary Public-State W Florida)
Personally Known OR Produced Identification Personally Known_0 OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. „ eM ICIA HERNANDEZ ommission No. Q�C1Si(n3 ,Pfle�" ea LICIA HERNANDEZ
YP�e�, :z' `�: Notar Public-State of Flori
Notary Public-State of Florid •�« y
="�,,F oP� My Comm.Expires Jul 13,2019 �N1•�FOFF�°P� My Comm.Expires Jul 13,20
Revised 07/15/2014 OF F� . Bonded through National Notary Assn. Bonded through National Notary As
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE. LA 6�COMPLETE
INITIALS