HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICeCABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 0�31aJ Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 7601 Bayard RD Fort Pierce, FL 34951
PropertyTax ID ri: 1302-810-0031-000-3 Lot No. 4
Site Plan Name: Block No. B
Project Name: Hartlaub Residence
DETAILED DESCRIPTION OF WORK:
INSTALLATION OF SOLAR PV SYSTEM TO ROOFTOP
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION: l
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Pond
� ggx ElegctriicgR _Plumbing _Sprinklers _Generator _Roof Pitch
Tonal Sq. Ft of R GRrOU KIMANDY LAWRENCE EC13005 g4Ft. of First Floor:
Cost of Construction: $ 20,900 Utilities: -Sewer _Septic Building Height:
OWNER/LESSEE: : CONTRACTOR:
Name Vickie L Hartlaub i Name: MICHAEL VERGONA
Address: 76ot Bayard RD , Company: URBAN SOLAR GROUP
City: FORT PIERCE Stater Address:_Aan S RQC;FRS C.iR RTF c
Zip Code: 34951 Fax: City: BOCA RATON State: FL
Phone No. 561-609-2664 Zip Code: 33487 Fax:
E-Mail: PERMITTING@URBANSOLAR.COM Phone No 561-609-26664
Fill in fee simple Title Holder on next page(if different E Mail PERMITTING@URBANSOLAR.COM
from the Owner listed above) State or County 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.
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 reviewyour deed for any restrictions which may apply.
In consideration of thegranting 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 commencingwork or re cordin our Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF_— Palin
Sworn to(or affirmed) and subscribed before me of x Physical Presence or_Online Notarization
thisdayof SJ 2024 by
MICHAEL VERGONA
Name of person making statement.
Personally Known Y, OR Produced Identification
Type of Identification Produced
U1 ��
(Signature of Notary P II -Statli of Florida )
Commission No. I 1 I"{-1I3901v ,'.','°.m"""""' VICTCRIAWAGNER
IT (Seal) :` °` '" MYCOMMISSION#HH113906
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EXPIRES:April 5,2025
'1$e""d"4, Bonded Thru Notary Public Undereriterm
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
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