HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential Mcxxxxoa
PERMIT APPLICATION FOR: Building
PROPOSED IMPROVEMENT LOCATION:
Address: Qqa e %_o. l ��� Fvr}
Legal Description: 12 35 38 N 250 FT OF NW 1/4 OF SW 1/4 OF NW 1/4-LESS RD AND CANALS-(3.50 AC)(OR 3815-986)
Property Tax ID#: 2212-232-0001-000-7 Lot No.
Site Plan Name: Dominic Capretta Lorene A Capretta Block No.
Project Name: Dominic Capretta Lorene A Capretta
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:T
Solar PV System Roof Mount & Interconnection
CONSTRUCTION INFORMATION:
Additional work to e ertorme un er his permit—Check all apply:
1JHVAC Gas Tank ❑Gas Piping In_Shutters ❑Windows/Doors
EJElectric El Plumbing OSprinklers E]Generator Roof_ Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 32750 Utilities:lSewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Cc_ ¢44-�=, Name: f14P,,a)
Address: r�Ro N 14Q� ,_ C any 1 (��.� Company: Go Solar Power LLC
City: �br' P;Qc c e. State:FL Address: G'�� L h n,� M"c,P, 1210
Zip Code: 34945 Fax: City:&.0Cc. R,-�-�� State:FI
Phone No.(772)475-9334 Zip Code: 33487 Fax:
E-Mail:greatdanegreats@gmaii.com Phone No. 561-228-4483
Fill in fee simple Title Holder on next page(if different E-Mail: Jackson@gosolarpower.com
from the Owner listed above) State or County License: CVC56962
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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 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
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.
Signa t actor as Agent for Owner Si rt ractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF stwde COUNTY OF&wde
The fgWing instrument was acknowledg efore me The f oing instrument was acknowledgqyPefore me
this day of June 20�by this day of June 20_ by
Rafael Gonzalez Mendoza POA Rafael Angel Gonzalez Mendoza
Name of person king statement Name of peaking statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
( e of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Com Sion No.
! ��"" (Sealy Public State of Florida COm4s�onNo. Q �r �ub,ic State of Ffcrida
Jackson Dash Mclnerrl�y w A,f Jackson Mesh Palcinern Y
My commission HH 031240 Commission HH 031240
Expires 08/1 1/2024 46 Expires 08111/2024
A,
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17