HomeMy WebLinkAboutBUILDING PERMIT APPLICATION ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: PKAS us %2020 Permit Number:
- J
•
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: Alteration
PROPOSED IMPROVEMENT LOCATION:
Address: 426 SE Gasparilla Ave Port St. Lucie, FL 34983
Legal Description: RIVER PARK-UNIT 4 BLK 35 WLY PART OF LOT 5
Property Tax ID#: 3419-530-0103-000-5 Lot No.5
Site Plan Name: Block No.
Project Name: ��11o,c�o n 'so VZoc�p
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Installation of Tesla Solar Roof and Tesla Powerwall(s)
CONSTRUCTION INFORMATION:
Additional work to be pertormed under this permit—check all that apply:
— HVAC _Gas Tank Gas Piping Shutters Windows/Doors
s — — —
E ✓ Electric _Plumbing —Sprinklers —Generator —Roof Roof pitch
0
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ l&C9l . —Sewer —
OWNERAESSEE: CONTRACTOR:
0
o Name Tiffany Nicole Wiggins Name: Nick Armstrong
m
Address:426 Southeast Gasparilla Avenue Company: Tesla Energy Operations, Inc.
City: Port St. Lucie State: FL Address: 8500 Parkline Blvd. Ste 100
Zip Code: 34983 Fax: City: Orlando State: FL
w Phone No.5616672896 Zip Code: 32809 Fax:
w E-Mail:jovenvillaman@gmail.com Phone No. 46 S 10
Fill in fee simple Title Holder on next page (if different E-Mail: orlandopic@tesla.com
w
from the Owner listed above) State or County License: EC13006226
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
www docv rif CD6F5EBC-4485-492E-97FE-540056617189 Page 2 of 5 254005B617189 ,III y' �,I III
www.docverifycom (�i.
SU PLE11/I NTAL CON TRUCTlON LIED LAW 1 FORMAXJ
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 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 attorneyOOL&ore commencing work or recording our Notice of Corwencement.
Signatur of dwW7 essee/Contractor a t for Owner Signature of ont ac , L cense Holder
STATE OF FLORI A STATE OF FLORIDA
COUNTY OF CXC{n,J-E COUNTY OF Qfafli►C
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 day ofFCbY UCi V' 202� by this,�day of ,br Y 2020 by
Ni&, o1as rms�rninc4 Nlcholds ro-15fry
Name of person making statement. J Name of person making statement.
Personally Known X P d wt' Ic ti Personally Known arnd u I& 'fi at' n
ref I� t U IL�AS Iderrtif ttcTrl— of ��®, STEPHANIE OENISE TUBILLAS
Produced NotaryPublic•State of Florida Produced N ?• ` : Nota Public State of Florida
a _
Commission#HH 062796 ' `' Commission r HH 062796
oFp+ - My Comm.Expires Nov 12,2024 q,F c�,. My Comm.Expires Nov t2,2024
ad
Bonded
(Si nature of o��tllary P (Si nature of otary Publ
Commission No.414Q62`1 q (Seal) Commission No.-H'N0(02._7C{ (c, (Seal)
i
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
UM E
RECEIVED j
DATE
COMPLETED
eV.