HomeMy WebLinkAboutPermit ApplicationAll APPLICABLt INFP MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:.2/22/21 IPermit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierre FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Residential xx
PERMIT APPLICATION FOR: pool Solar
PROPOSED'IMPROVEMENT LOCATION:
Address- 4820 Southwind Trail
Property Tax ID #: 1418-133-0015-000/3
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
install solar panels for swimming pool.
t
New Electrical Meter Second Electrical Meter
[CONSTRUCTION INFORMATION:_
Lot No.
Block No.
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 1200.00 Utilities: -Sewer _Septic Building Height:
-OWNER/,LESSEE:
-CONTRACTOR:
Name Joseph W. Fersch
Name: Joseph W. Fersch
Address:4820 Southwind Trail
Company:
City: Ft Pierce State: _
Zip Code: 34945 Fax:
Phone No.
Address.4820 Southwind Trail
City: Ft Pierce State. FL
Zip Code: 34945 Fax:
Phone No
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail
State or County License
If value of construction is 2500 or more, a RECORDED Notice of Commencement is regwrea.
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:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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.
Inconsideration 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 recordine vour Notice of Commencement.
Sign e o Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STA OF FLORIDA
STATE OF FLORIDA
COUNTYOF ;����fC.
COUNTY OF
Swflrn to (or affirmed) and subscribed before me of
✓
Sworn to (or affirmed) and subscribed before me of
PAyslcal Prelseuc� or_Online Notarization
Physical Presence or Online Notarization
this O day of .I �� . 202f by
this _ day of 12020 by
Joseolti ���c �
Name of per o making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Pu c- State of Florida)
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
Commission
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DATE
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DATE
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Rev. S/b/21.1