HomeMy WebLinkAboutSigned Building Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Ll
—� -- — Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 4624553 Fax: (772) 462-1578 Commercial Residential x
PERMIT TYPE: Solar Permit
PROPOSED IMPROVEMENT LOCATION:
Address; 2355 Dyer Road, Port St. Lucie, FL 34952
Property Tax ID #: 3414-501-1409-300-5 Lot No. 9
Site Plan Name: Douglas DiJov Block No. 2
Project Name: Douglas DiJoy
DETAILED DESCRIPTION OF WORK:
Installation of a Roof Mounted Photovoltaic Solar System
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
X Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 47,591096 Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Douglas DiJoy
Name: Daren Goldin
Address: 2355 Dyer Road
Company: Goldin Solar LLC
Address: 3447 Percival Avenue
City: Port Saint Lucie State: FL
Zip Code: 34592 Fax;
City: Miami State: FL
Phone No. 772-834-9075
Zip Code: 33133 Fax;
E-Mail: ddijoy@yahoo.com
Phone No 772-617-6830
Fill in fee simple Title Holder on next page ( if different
&Mail Permitting@goldinsolar.com
from the Owner listed above)
State or County License Florida
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement Is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:_
Address:
City: —
Zip:
Not Applica
State:
MORTGAGE COMPANY: — Not Applicable
Name:
Address:
City: State:
Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING CVlvlr/Alm Ira Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone, Zip: Phone.
UWNtK/ (:UN 1 KACTUR 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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
u ' tend to obi financing, consult with lender or an attorney before
before the first inspection. If
commencing work or pecordina volur Notice of Commencement.
Signature of Owner/
ctor as Agentfefr Owner � Signature of Contractor/License Ho
STATE OF FLORIDA/` r � STATE OF FLORIDA �J
COUNTY OF I i�C (� COUNTY OF rlClh'I/ — Ivac��
The forgoing instrumen as � knowled d efore me
this+ --day of � � 20by
Name of person aking statement.
Personally Known OR Produced Identification
Type of Identifj atipn
Pro7d ee(� /
(Si�"nature of Nota/�/Public- State of FI '
U L�
Commission No. (� f
The forgoing instru nt was acknowledged before me
this � day of �b
AQre
Name of person mak
ing/statement,
Personally Known V OR Produced Identification
Type of Identification
Produced
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REVIEW
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COMPLETED