HomeMy WebLinkAboutBuilding Permit App & Sub-Agreement All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
COUNTYST. LUCIE
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
23W Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 6500 LAS PALMAS WAYPORT ST LUCIE, FL 34952
Property Tax ID#: 3415-504-0012-000-7 Lot No.
Site Plan Name: Block No.
Project Name: OLIVO PV
DETAILED DESCRIPTION OF WORK:
INSTALLING A 5.76 KW ROOF MOUNTEED SOLAR PHOTOVOLTAIC SYSTEM
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:$ 25,515 Utilities: —Sewer _Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name DAVID OLIVO Name:RAYMOND MEAD
Address:6500 LAS PALMAS WAY Company:LSC1 INC.
City: PORT SAINT LUCIE State: Address:7300 BRYAN DAIRY RD. STE 400
Zip Code: 34952 Fax: City: SEMINOLE State:FL
Phone No.(786)299-1985 Zip Code: 33777 Fax:
E-Mail:BLACKBEARD201 @OUTLOOK.COM Phone N0727-571-4141
Fill in fee simple Title Holder on next page(If different E-Mail PERMITS@SUNTECSOLARENERGY.COM
from the Owner listed above) State or County UcenseCV0056656
If value of construction Is 2500 or more,a RECORDED Notice of Commencement is required.
If value of HAVC Is$7,5W 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:
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 Homeowners 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 allerney before commencing work or recordinit Your Notice of Commencement.
26-� Z4.2=2— z�//7
Si nature of OwnerX Lessee/Contractor as Agent for Owner Signatur ontractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF t11.P�E no t- COUNTY OF
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
YPhysical Presence or Online Notarization _Physical Presence or Online Notarization
this day of 2020 by this day of 2020 by
Qom.►"Wh 23k-l� . V.bd a "1� M
Name of peaking statement Name of person making statement
Personally Known ?5- `OR Produced Identification Personally Known< OR Produced Identification
Type of identification Type of Identification
Produced 4 Produced
LIUMIfure of Nota P -State of Florida) (Sf Notary i of Florida)
Commission No. 621-4 ,rZ:16 2 (Seal) Commission No. Cis V7612— (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
rev. SITYLA CORSON
?o`�Y�uA's State of Florida-Notary Public �„��u,, SITYLA CORSON
Commission # GG 227512 _.$ State of Florda-NoGa22 P512c
June 12, 2022 :� ` MY vmrn
'N a h��r oP,:
June 12, 2022
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PERMIT iI ISSUE DATE
_ PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
� COUNTY
BUILDING PERMIT
SUB-CONTRACTOR AGREEMENT
DOUGLAS DANKNER have agreed to be
(Company Narne/Indiiidual Name)
the ELECTRICAL Sub-contractor for RAYMOND MEAD
(Type of Trade) (Primary Contractor)
For the project located at 6500 LAS PALMAS WAYPORT ST LUCIE, FL 34952
(Project Street Address or Property Tax ID#)
It is understood that, if there is any change of status regarding our participation with the above mentioned
project, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
filing of a Change of Sub-contractor notice.
CONT&ACTOR SIGNATURE(Qualifier) SURCONTRACIM SIGNATURE(Quatltier)
q__--ty"a rvn M ff Ln —Tw!�tn LAts
PRINT NAINIE P ANEE
C%fCic,S6- c ,s C t 3 C,Q 13�a
COUNTY CERTIFICATION\LNIBER COUNTY CERTIFICATIO\WN BER
Stale of Florida,county of::P�E&i^etA cti State or norlda,County of�t�A IIb C
The foregohg ttr#mn nt was sighed before me this w I day of The foregoing Instrument was signed before me this day of
M A-\I zoz,by Pra►. ervil o w:> „M=�2 Urn n�t�
who is personally(mown x or has produced a who Is personally ImowaX or has produced a
as identification. as identification.
11 4 STAMP �/) STAMP
SI of any Public Signature of Notary Public
Print Name o - otary Public Print Name of otary-Public
SITYLA CORSON SITYLA==� ,u
:� :State of Florida-Notary Public aor" '�e
Rc��sed llll62 i. - f,_ Cte of FloCommissiCommission a GG 22/512 �+ YIVY Ccmrnission Expires ', Ea uA' M Comes
June 12, 2022
Jun
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