HomeMy WebLinkAboutPermit Application - Wells All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential x
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT tOCATION:
Address: 6014 ROLAND CT FORT PIERCE FL 34951
Property Tax ID#: 1302-810-0107-000-7 Lot No.5
Site Plan Name: Block No. E
Project Name: WELLS EDWARD
DETAILED DESCRIPTION OF WORK:
ROOF MOUNTED SOLAR PV SYSTEM INSTALL 11 52 KW
New Electrical Meter Second Electrical Meter (Affidavit required)
COI'tSTRUCFtON WFORMATIfJN: t
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors _Pond
_Electric _Plumbing _Sprinklers ,Generator _Roof Pitch
Total Sq.Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ Utilities: —Sewer _Septic Building Height:
OWFNEWLESSEE: CON 1 ACTOR:
Name FIDWARIDWFTTS Name: NORMANPURK17Y
Address: 6014 ROLAND T _ Company: cn1 Au BEAR 1 i C
City: FART PTFRCF, State:_EL Address: 6101 IQHNS RD.SUITE 8
Zip Code: 34951 Fax: City: TAMPA State:_
Phone No. 77? i47 4s4a Zip Code: 33634 Fax:
E-Mail: FTWFT T 1;JR(@r.MA11 C0M Phone No 797 471 7442
Fill in fee simple Title Holder on next page(if different E-Mail i0FTrap0URSQ ARRFAR CnM
from the Owner listed above) State or County License EC13006630
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.
Stipp EMENTAL CONSTRUCTION LIEN LAW kDFfOtt
DESIGN E 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 prohlbit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
Inconsideration 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 our Notice of Commencement.
15- 4��-t
Signature of OvmUrrr9We—e7I7ohtractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF HILLSBOROUGH
Sworn to(or affirme and subscribed before me of ✓Physical Presence or Online Notarization
this 71- dayof + _,20,94 by
NORMANPURKEY
Name of person making statement.
Personally Known OR Produced Identification ✓
Type o Identification Produced 7]�uryec Gccw>XiE
ature t Notary Public-State of Florida)
Joseph Tribou
Commission No. NN 4M67 (Seal) Notary Public,State of Florida
MY Commission Expires 12/07/2024
Commission No.HH 69907
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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