HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 5308 HICKORY DR, Fort Pierce, FL 34982
Residential
Property Tax ID #: 3402-608-0460-000-1 Lot No. 20
INDIAN RIVER ESTATES -UNIT 07- BLK 52 LOT 20 (MAP 34/02S)
Site Plan Name: OR 435-2242: 2835-2650) Block No. 52
Project Name: Sandra Mo e
DETAILED DESCRIPTION OF WORK:
Installation of Roof Mounted PV Solar
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: 609.15 SQ FT
Cost of Construction: $ 25, 920.22 U
OWNER/LESSEE:
Name Sandra Moge
Address: 5308 HICKORY DR
tern
Windows/Doors Pond
Generator Roof Pitch
Sq. Ft. of First Floor:
tilities: —Sewer —Septic Building Height:
City: Fort Pierce State: FL
Zip Code: 34982 Fax:
Phone No. (772) 216-0586
E-Mail: mogesandra@gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: Greq Albright CCC 1332814 EC 13008056
Company: Freedom Forever FL. LLC
Address: 3590 NW 54th St Suite #3
City: Fort Lauderdale State: FL
Zip Code: 33309 Fax:
Phone No (476)301-1674
E-Mail Permitslauderdale@freedomforever.com
State or County License Florida
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: I
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
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Narne:
Address:
Citv:
Zip: Phone:,
_Not Applicable
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 review your deed far 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 concurrencyreview: room additions,
accessory structures, swimming pools, fences, walls, slgns, 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 prop rtyA Notice of Commencement must be recorded in the public records of St.
j
Lucie County and posted oche obsite before the first inspection. If you intend too ain financing, consult
with lender or an/,Worney fpre commencing work or recording our No ' e of Coftnencement.
Signature of Owner/ Les e/Contf a�tor as Agent for Owner I Signature of
STATE OF FtrORlbq , FLORIDACOUNT V W 4,
COUNTY OF i3�'o �
Sworn to for affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization _ Physical Presence or Online Notarization
this _ day of 12020 by this _ day of _ 2020 by
fly Gri A� t i 5L� -
Name of person making, statement. Name of person making statement.
Personally Known OR Produced Identification Personally K own ✓ OR Produced Identification
Type of id Ification Type of Ide fic, Von
Produced_ Produced —
(Signature tote of Florida ) ' (Signature of Notary Pu ic- XMe of Florida )
Commission
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REVIEWS
DATE
RECEIVED
DATE
Commission No.
PLANS VELETA'
REVIEW REVIEW
Notary Puck 5mis of Ffal
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