HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5/14/21 Permit Number: 2.\cN%c'G636
' RECEIVED
NIP Building Permit Application JUN 01 2021
Planning and Development Services Permitting Department
Building and Code Regulation Division Commercial Residentialmt. Lucie0Gnty
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Sd�a 4„
.`PROPOSEDP`IIVI 40VE1;', LOCI ION , M
Address: 288 N FFA RD. FORT PIERCE FL 34945
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name: RUPPERT
INSTALL 7.68KW ROOF MOUNTED PV SOLAR WITH (24) MODULES AND
(24) MICROINVERTERS
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 24,000
(Affidavit required)
Windows/Doors _ Pond
_ Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
01�VNR/LESE�
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�' �� ' `CONTRACTOR�� r�6�
NameALLEN RUPPERT
Name:
Company:
Address:288 N FFA RD
City: FORT PIERCE State: FL
Address:
Zip Code: 34945 Fax:
City: State:
Phone No.772-834-0026
Zip Code: Fax:
E-Mail:ALLEN.M.RUPPERT@GMAIL.COM
Phone No
Fill in fee simple Title Holder on next page ( if different
E-Mail
from the Owner listed above)
State or County License
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.
..,,.E
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 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 attornev before commencine work or recordine vour Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
LOClie,
STATE OF FLORIDA
COUNTY OF ,
COUNTY OF
Swor 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 M day of 2by
this _ day of 20_ by
Name of person ma'KW statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identificati_op.
f �--�
Type of Identification
Produced
Produced
(Signature of Nota I c-
(Signature of Notary Public- State of Florida )
Notary Public State of Florida
Lori A�ih�o�y
Commission No. My Cod on HH D2s20s
Commission No. (Seal)
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