HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
[date: Permit Number:
Lt La
t L c ` t L' 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: 1450 Copenhaver Rd
Property Tax III#: 2313-132-0001-000-0 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
roof mounted PV solar and interconnection
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/Moors Pond
Electric —Plumbing _Sprinklers —Generator —Roof Pitch
Total Sq. Ft of Construction: Sq. Ft of First Floor:
Cost of Construction:$ Text Utilities: _Sewer _Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name r]nrnt }t.IflklnSOt� Name:_ Richard i
Address: 1450 Copenhaver Rd Company. F=inr a�t�a p
-.-ewgr-Nl�xr agexx�er�
City: End pierce State:_FL._ Address: I_q11 Grp,,, pnresti,t
Zip Code: Fax: City: Minter Garden State: FL
Phone No...�779 21F_��0 Zip Code: 3s1787 Fax:
E-Mail: alan,johns y;hoQ.cnm Phone No 407-554 2p47
Fill in fee simple Title Holder on next page(if different E-Mail__
ir�nna n mc�ic`1:�:.A3rX?
from the Owner listed 81JOVe) State or County License F�1 irlflt3fi45
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 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 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 commencin work ar recordin our Notice of Commencement.
Signature oferj JCo ractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF *
Sworn to (or affirmed)and subscribed before me of Physical Presence or Online Notarization
this �day of u t�fi�_, 20� by
d C)
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification Produced VQXS C
c�e�walloLc.�
(Signature of Notary lic-State of Florida)
Commission No- � I��L'O"1 (Seal) E
NICOLE PJ WALLACE
Notary Public-State of F,orica
Commission nHH 1462%s
My Comm.Expires JLr 28.2Q2i
ded through National Notary Assr.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev /20/21