HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE IN O MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: V� oI y Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, FortPierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 3601 Sleepy Hollow LN Port Saint Lucie, FL 34952
Property Tax ID q: 3425-705-0025-000-9
Site Plan Name:
Project Name:
STOLZE ESIDENCE
DETAILED DESCRIPTION OF WORK:
Residential X
Lot No. 24
Block No. 41
INSTALLATION OF SOLAR PV SYSTEM TO ROOFTOP
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed 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: 1 Sq. Ft. of First Floor:
Cost of Construction: $ 1 11 d -7 S' Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name William J Stolze
Name: MICHAEL VERGONA
Address: 3601 Sleepy Hollow LN
Company: URBAN SOLAR GROUP
City: Port Saint Lucie, State: FL
Zip Code: 34952 Fax:
Phone No. 5616092664
Address: 990 S ROGERS CIR STE 4
City: BOCA RATON State: FL
Zip Code: 33487 Fax:
Phone No 5616092664
E-Mail: PERMITTING@URBANSOLAR.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-
Mail PERMITTING@URBANSOLAR.COM
State or County CVC56948
License CVC56948
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: 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.
1 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 attorney before commencing work or recording your Notice of Commencement.
Signature of ontractor icense Holder
Signature o Owner/ Lessee Contractor as Agent for Owner
STATE OF COUNTY OF FLORIDA Falm ,� „n' _
COUNTY OF STATE OF FLORIDA POI m
Sw�9tn to (or affirmed) and subscribed before me of
1� PhysicalPres nceor_OnlineNotarization
this�dayof �2024 by
Sworn to (or affirmed) and subscribed before me of
X Physical Preseppceor_ Online Notarization
this � day of %UAre— 20 21 by
MICHAEL VERGONA
MICHAEL VERGONA
Name of person making statement.
Name of person making statement.
Personally Known —, L OR Produced Identification
Personally Known Y� OR Produced Identification
Type of Identification Produced
Type of Identification Produced
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