HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
1
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300V1rginlaAvenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
- - - -_ - -
Address: 5110 Palm DR Fort Pierce, FL 34982
Property Tax I D#: 3402-608-0354-000.5 Lot No. 6
Site Plan Name: Block No. 50
Project Name: Amy Bilodeau RESIDENCE
DETAILED DESCRIPTION OF WORK:
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
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 25//, 155� Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: , CONTRACTOR:
Name Amy Bilodeau Name:MICHAELVERGONA
Address: 110 Palm DR Company:URBAN SOLAR GROUP
City: Fort Pierce State: FL Address:990 S ROGERS CIR STE 4
Zip Code: 34982 Fax: City: BOCA RATON State: FL
Phone No.5616092664 Zip Code: 33487 Fax:
E-Mail: PERMrrriNG@URBANSOLAR.COM Phone No 5616092664
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
— — --- -a— - - - ---
H value of construction is 2500—or more, RECORDED Notice of Commencement is required.
R 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: _
Ap. Phone__ _ Zip: Phone:
FEE SIMPLE TITLEHOLDER: __ 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 certifythat 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 bul Id 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.
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-resldentlal 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 attome before commencing work or recordingour Notice of Commencement.
Signature of wner/Lessee/Contractor as Agent for Owner
STATE OF FLO
COUNTY OF_ c /\�
Sworn to(or affirmed) and subscribed before me of Physical Presence or_Online Notarization
this_4�dayof 2021 by
I
Name of person making statement
Personally Known i OR Produced ldentiflcation
Type of Identlflcatlon Produced
1 WLZ:-�-
(Slgnature of Notary lic- Florida )
�II3C� (Seal) > °b VICTORIA WAGNER
Commission No. Seal :� ' ":d;
MY COPRAISSION p HH 113906
of EXPIRES:A Apr o 2026
Bonded Thru Notary Public Undmotars
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
RECEIVED
CO PLETED
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