HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPUCABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
ar ter- -r
Permit Number:
NONE"
Building Permit Application
Planning and Developmeryt Services
Building and Code Regulotion Division
2300 Virginia Avenue
.. Fort Pierre FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR.
Commercial
� PROPOSED IMPROVEMENT LOCATION0
:
address: 654 Ponvtail LN Fort Pierce. FL 34982
Property Tax ID #,%L 341 0-503-0366m-000-5.
Site Plan Name: PA
ROVE S/D B
Project Name: Donna Gouin
DETAILED DESCRIPTION OF WORK:
T 28 (0.1
Residential
Installation of Roof Mounted PV Solar System
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
Lot No.28
Block No. L
_Mechanical _Gas Tank _, Gas Piping _Shutters Windows/Doors _Pond
I lumbing _Sprinklers _Generatof Pitch
Total Sq. Ft of Construction: 381 SQ FT Sq. Ft, of First Floor:
Cost of Construction: 24,309 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR-.
Name Donna Gouin Name: Greg, Albright
Address: 654 Ponytail LN company: Freedom Forever FL, LLC
city: Fort Pierce state: FL Address:,.3590 NW 54th St Suite #3
Zip Code: 34982MMENNEENEW Fax:- city: Fort Lauderdale StaYe:F
Phone No. (941) 270-6024 zip Code: 33309 Fax:
E-mail; bdaouinOWahoo.com Phone No C476)301 a-1 674
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Fi I I in fee simple Title Holder on next page if different E-MailPermitslauderda[eAfreedomforever.com
from the Owner listed above) State or County License EC 13008056 CCC 1332814
If value of construction Is 2500 or more, a RECORDED Notice of Commencement Is required,
If value of HAVC 6 $7,5W or more, a RECORDED Notice of Commencement Is required,
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
NameV,
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: V_. Not Applicable
Name:
Ad d ress 0
citybb State.
Zo
1p: P_Wmffivw� P hone
BONDING COMPANY:
Not Applicable
Name:
Address:
City:
Zip: Phone..
OWNER/ CONTRACTOR AFFIDVIT-.0 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 Countv makes no representation that is granting a permit wiEl aufiharize the permit holder to buifd tie subject structure
which is in tonict with any applicable Home Owners Assoctabon 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 concurrence review: room additions,
accessory structures, swimming pools, fences, wails, signs, screen rooms and accessory uses to another non-residential use
WARNING TO DINNER: Your failure to Record a Notice of Commencement may result in paying twice for
improvements to your property. A Notice of Commencement must be retarded in the public retards of St.
.0
Lucie County and posted on th e jobs ite before the first inspection. If you intend to ❑btaEn financing, consult
with lender or an attorr4v before commenciniz work or recvrdine vour Notice of mmencem-ent.
signature of Ownoe'r/ f�esee/
STATE OF FLORIDA %60'
COUNTY OF &low
attar as Agent for Owner I Signature of Cantra6tar/Mense
Sworn to (or affirmed) and subscribed before me of
Physical Prase ce or � Online Notarization
this day of 2020 by
STATE OF FLORIDA "
COUNTY of l3� 0
Eder
Sworn to (or affirmed) and subscribed before me of
Ph sisal Prase t
eor Online Notarizationthis , day of� 202 f by
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(Signature of N
Commission Nd.
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