HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: `O Z 2 Permit Number:
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Ly TPOKOWCOMPUTITBuilding 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: Laurie Seifert
PROPOSED IMPROVEMENT LOCATION:
Address: 268 NE Solida DR Port Saint Lucie, FL 34983
Property Tax ID#: 3419-570-0027-000-2 Lot No. 16
Site Plan Name: RIVER PARK Block No. 74
Project Name: Laurie Seifert
[DETAILED DESCRIPTION OF WORK:
Installation of photo voltaic solar panels on roof.
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:$ 58,942.00 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Laurie Seifert Name:Cameron Christensen
Address:268 NE Solida Dr company:Momentum Solar
city: Port Saint Lucie State: FL Address:6001 Hiatus Road#3 Tamarac, FL 33321
Zip code: 34983 Fax: city. Tamarac State: FL
Phone No.321 247 6073 zip Code: 33321 Fax:
E-Mail:flPermits@momentumsolar.com Phone No 321 247 6073
Fill in fee simple Title Holder on next page(if different E-Mail flPermits@momentumsolar.com
from the Owner listed above) State or County License CVC57036
If value of construction is 2500 or more,a RECORDED Notice of Commencement 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 MORTGAGE COMPANY: X Not Applicable
Name:Mina A. Makar Name:
Address:61 WINDLING WOOD DR APT 813 Address:
City: Sayreville State: NJ City: State:
Zip: 08872 Phone 551 589 5068 Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: X 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 nder or an attorneybefore commencingwork or recordingour Notice of Commencement.
L 'e-e J/0 "J/
Si ure f O r of Conw Lesse Contractor as Agent for Owner Signatu icense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF St Lucie COUNTY OF St Lucie
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 2nd day of June ,26ZIby this 18th day of November b
.al y
Ivelisse Quintero Cameron Christensen
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification X Personally Known X OR Produced Identification
Type of Identification Type of Identification
Produced DL Produced
00,
Signature of ry Public-State of Florida) 4(Si�ig�nat�urelof Notary Public-State or
ozP�`Y.:B�� EMILY R.RODRIGUE
Commission No. GG271264 * ' Seal ommission#GG 2712 aa�Y Puss, EMILY R.RODRIGUEZ
-Commission No. GG271264 rP•�" o(S
NT o� Expires October 25,20'2 , * mission#GG 27126
9lFOF F���` Bonded Thru budget KotarySe••;res Expires October 25,2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev.5/6/20