HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED -
Date: Permit Number:
1 L Q L l: b Oti _ Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential x
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: roof top PV solar
PROPOSED IMPROVEMENT LOCATION:
Address: 1971 S Brocksmith RD Fort Pierce, FL 34945
Property Tax ID #: 2317-314-0002-000-7 Lot No.
Site Plan Name: Block No.
Project Name: Anderson -Solar
DETAILED DESCRIPTION OF WORK:
roof mounted PV solar and interconnection
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
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: $ 32500 utilities: T Sewer ! Septic
Building Height:
OWN ER/LESSEE:
CONTRACTOR:
Name Henry Anderson Jr.
Name: Richard Longo Jr.
Address:1971 S BROCKSMITH RD
Company: Florida Power Management
Address:1331 Green Forest Ct. #3
City: Fort Pierce State:
Zip Code: 34945 Fax:
Phone No. (772) 332-6153
City: Winter Garden State; FL
Zip Code: 34787 Fax:
Phone No407-554-2047
E-Mail: jranderson1930@gmaii.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail jenna@fpmsolar.com
State or County License EC13008645
r� -0 Ur vW113L1ULUVII IJ 43VU Or MOre, a Kr-LUKutu nonce Oi Uommencement 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:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: 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.
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 attorney before commencing work or recording our Notice of Commencement.
Signature of Contractor/ ' en older
Tignature of Owner/ Lessee!/Con*Tct1Vas Agent for Owner
STATE OF FLORIDA
COUNTY OFSI- C(AcLe
STATE OF FLORIDA
COUNTY OF S1 • L t6_c
S or�n to (or affirmed) and subscribed before me of
1� Physical Presence or Online Notarization
this S-i�" day of ri 202$ by
S orn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this ,51 day of ' "rif_ — , 2020 by
/` �c�t�t�� Gor►Ao . �•
�t c�rar-o� �n n r
Name of person making atement.
Name of person making state ent.
Personally Known OR Produced identification
Personally Know OR Produced Identification
Type of Identification
Type of identification
Produced
Produced
(Signature of Notary Public- Stat', ) ryTINAM STEWARD
r �? Nota Public State of ;i
Commission # HH 723
Commission No. 72ov�e Comm. Expires Dec 15,
Bonded through National Nota ry
(Si ature of Notary Public- State of lgo6�}g�.. TINAM STEWA
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9 ^ Notary Public -State
2t mission No'�I/ -7Z� :� "1) Commission R HH
Assn, oFr�,:; My Comm. Expires De
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REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Re—v75/15/20
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