HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR'.APPLICATION TO BE ACCEPTED
Date:.. Permit Number.. i1,'(�rl
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Building Permit Application
Planning and Development Services
Building-and Code Regulation:Qivision Commercial. - Residential X
2300 Virginia Avenue,Fori Pierce FL 34982
Phone:{77.2)452-1553 Fax:,(772)462-1578.
PERMIT APPLICATION FOR':
PROPOSED IIUIPRC}11E1t%�ENT-LOCATIf3I�.
Address: 795'Sandia AVE.Port':Saint Lucie, FL,34983
PropertyTax ID^#': 3419-550-0079-000=9 Lot No.8 -
Site Plan-_Name; Block"No. 68
Praject:Na.me: SMITH RESIDENCE
DETAILED DESCRIPI'lON C3F WORK
INSTALLATION OF SOLAR PV SYSTEM TO:ROOFTOP
,New Electrical Meter Second Electrical.Meter (Affidavit required}
CO ,
NSTRU,CTION INFORMATION
Additional work to be perform ed Under this permit—.check all that apply
_Mechanical _Gas Tank _:Gas Piping. _Shutters _Windows/Doors Pond.
X Electric Plumbing _:Sprinklers _Generator _Roof Pitch
_ .
URBAN SOLAR GROUP/KIMANDY LAWRENCE EC13005324
Total Sq.Ft of Construction: Sq. Ft..of First.Floor:
Cost.of Construction:$ ;4 Utilities: Sewer :Septic: Building Height:
QINNER LESSEE G0NTRACTQR.
Name Saly f leang.Kasandra Smith MICHAEL VERGONA.
Name
Address:795 Sandia AVE Company:URBAN SOLAR GROUP
City: Port.Saint Lucie State:FL Address:990 S ROGERS.CIR STE 4
Zip Code: 34983 Fax: City: BOCA RATON State:FL
Phone No.5616092664 Zip Code: 33487 Fax:.
E-Mail:-PE,RMITTING@URBAN.SOLAR..COW Rhone No 5616092664
Fill in.feeaimple Tltle'Holder on next page(if different E
from the OwneHisted above) Mail PERM ITT ING@URl3ANS0LAR COM
State or County CVC56948
License CVC56948
If value of.construction is2500 or;more,:a RECORDED Notice of Commencement is required.
if value of RAVC is$1,SQ0 or more,.;a RECORDED Notice of'Commencement is required.
S�iPPLN1EiT, L Co1U5TRUCTIaN:LtEi IAUV iNFQRMATIot .
t?ESIGNER ;ENGIN€ER: Not i4ppiicable MORTGAGE COMPANY; iVot Not
Name: Name:
Address: Address:
City:- State: City: State:
Zip: Phone dip: Phone:
FEE"'S MPLE TITLEHOLDER:. !Not Applicable BONDING CO(WpAr, Y: 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 orinsta)lation has.commenced prior to the issuance of a perrnit:
St.Lucie County makes no.representation that is granting a permit will authorize the permit holder'to build the sublect'structure
which is in conflict"vaith 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 your deed for any restrictions which may"apply.
In consideration of.the,..granting of this requested permit,1 do hereby'agree;that I will,in ail 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 far
improvements to.your property.. A'Notice of Commencement must'be recorded in.the public records of St.
Lucie-County and posted' on the joiasite before:the first inspection. if you intend to obtain financing;
consult with lender or an attorney before commencing work or recording your otce f Commencement.
Signature of Ownert Lessee/Contractor as.Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA �. STATE OF FLORIDA
COUNTY OF�`��j l'n� b'e:c c n COUNTY OF ,�`1�'
Sworn to(or affirmed)'and subscribed before me of Sworn,to(or affirmed)and subscribed before me of
Physical-Presence or Online Notarization > Physical Presence or Online Notarization
this- V day of i�l�l_y" P_ ,20 by this f day of_ l�i t t.l 20 by
MiCHAEL VERGONA MICHAEL VERGONA
Name of person making statement. Name of person making statement.:
Personally Known OR Produced identification Personally Known >< _OR Produced Identification
Type of identification-Produced D i Type of Identification Produced
(SigttatUre of Nbtary Pu I
..Y.� — (Signature of NetaryPublic-
"`"` CAR OLYN kASLER
�CARC}LYN KASLE;R Notak� tic-State of Florid r v,
Commission No, �aI Commission No.. r s 1 l ( �,
�oi'�mi sion•it HH 67659 _ -
Noi hiic-Stale rat Fior.itia
�`� My Commission Expires { {i y1 ? Commission # Hti 67659
t35- %.,`,";;A;�`` `�L' E 10 a. My Commissions Expires
November 30, 2024 ;;. November 30,Expires
rws• m�s�,rc
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