HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
r _ Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-IS53 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 8403 FORT WALTON AVE FT PIERCE, FL 34951 - 1398
Property Tax ID q:
Site Plan Name: _
Project Name:
1301-606-0029-000.6
DOVER PV
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK:
INSTALLING A 5.76KW ROOF MOUNTED SOLAR PHOTOVOLTAIC SYSTEM
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
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 23,328 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:,
Name LUCITA DOVER Name: RAYMOND MEAD
Address: 8403 FORT WALTON AVE Company: LSCI INC.
City: FORT PIERCE State: FL Address7300 BRYAN DAIRY RD. STE 400
Zip Code: 34951 Fax: City: SEMINOLE State. FL
Phone No. 772-453-3524 Zip Code: 33777 Fax:
E-Mail: LUCITA.DOVER@GMAIL.COM Phone No 727-571-4141
Fill in fee simple Title Holder on next page ( if different E-Mail PERMITS@SUN i ECSOLARENERGY.COM
from the Owner listed above) State or County License CVC056656
If value of construction is 2S00 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.
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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 countty� makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conf]ict 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 res:r:ctions 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 tender ovfn attorney before commencing work or recording our Notice of Commencement.
Signatu a of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me of Ni/.-- Physical Presence or online Notarization
this _kzP day of2e7_-2,1 by e"fvNQ fait] V--D
Name of person making statement.
Personally Known _ OR Produced Identification
Type of Identificatio Produced
(Signature of Notary Public- State of Florida)
SITYLA CORSON
Commission No.C2Z95�Z (scat) :*"'�:'.
riState of Florida -Notary Public
_ Commission M GG ?27512
My Commission Expires
June t 2, 2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION ISEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEVJ REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev S/2u/2
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