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BUILDING PERMIT APPLICATION
i I 5 AItAPPLiCABLEINF0 MUST RE COMPLETED-FOR APPLICAT[ON'TO:BE ACCEPTED Date: Permit.Number: gr 11 L R UBLUEB 9.ilding,Permit. cation ! Pianning;a�td Development Services G Burldmg and Codi',Reguloiion Division Co:rht i&dal. R@Sidenfial X. r _. 23©a Virgrn►a,Avenue,Fort Pierce A 34982 Phone:(7i '46.' 1553 Fax `(T72}462'=1578 PERMIT APPLICATION 1 FOR: PROPOSED IMPRQVEMNT I.QCATION: a Address: 6866 Donlon RD Fort Pierce; FL 34951 Property.Tax ID;#: 1-8,1-'at3 0025=000-0, Lot.No..25 Site.Plan°Name __ Block:No. 137 P'roject:Name:. VE;LEZ.RESIDENCE: tETAILED DESCRI,PTiON°OI=iNORKs s. INSTALLATIQNP C?F SOLAR PV-SYSTEM.TO ROOFTOP New.Eiectrical Meter. A... Second,Elet rical',Meter {Affidavit r.•equired} L CONSTRUCTION INFORMATION r' s . Addt0dnal.workta be-performed under this permit-check all-that apply: _ Mechanical _Gas Tank _.Gas"P.iping _Shutters: _Windowsjpoors' _Pond _Electric _Plumbing _Sprinklers Generator _Roof Pitch , Total`s . Ft of Construction:.,q Sq.;Ft-of Fist:Floor Cost of Construction:•$ 3.3 Utilities: Sewer _Septic . Building Height: OWN,ERjLESSEE CUNTRRG7tJR X ; Name Carlos Velez;Juarnta i/elez Name, URBAN SQLAR GROUP/MICHAEL VERGQNA, Address: 68;05 Donlon;Rl Company;. URBAN SOLAR_ _Q_UP. city: FORT PIERCE 990 s ROGER8 OlR-s,TE.4 State:FL, Address: Zip-Code: 34951 Fax:, City: BOCA RATON`: State: FL Phone.No. 56.1:6Q926:64_1 Zip Code::3348T Fax: E=Mail PERMITTING@URBANSOLAR C:OM Phone No 561fi092664 Fill:ih fee simple Title Holder on next page:(if different 'E-Mail PERMITTING@URbANSQLAR:CtOM #ribm:thd Owner listed above}, State or ,ounty License ,CVC,56948 If value of construction,is 2500 or more,a.RECORDED,Notice-of Commencement°isrequired. If value of:`HAVC is;$7,500 or more,a RECORDED Notice.of Commencement is.required.. UPPLEMEf €AL COPUSTRt1G1't�N,LtEN LAW ffFOtitiATIN pp MORTGAGE COMPANY. dESfGNERjENGINEER; —Nat.A Iicable _Not Applicable Name:; Na'me _. Address Address'. City: State.; _ ; City:. Stafte Zip. Phone Zip:, Phone- FEE<SIMPLE`TITLE HOLDER:, Nat Applicable" BONDING CC3NIPANY: Not Applicable Name: Name:: Address: Address;:. - City; City: Zip;.. Phone:' .." Zip Phone: ®V1tlUER/'CONTRACTOR AFFIDVIT Appircation is.hiereby made:to'obtziiii a'pertnit'to do ti a w6rk and installaiion_;as indicated. I certify that no°work or installation has.commenced priorto the.A"gance-of a,'permit St Lucie:Counttyy makes no representation•that is-granting a permit will',abthorad the� ermit holder to build the subject structure. 'Which is in confiitt-,With.any applicable Home Owners Association,,rules,bylaws ar an covenants,that may-restrict,or prohibit'such. striidure..Please.consult.with yoilr Home Ownels',Association and-review your deed for any resfrictions which may apply: ' Inconsideration of' the. of this requested;.perm'it,.i do hereby agree that I will,in all respects;.perform:the.work in'accordance with the approved p!a"ns,.fhe Florida`Suilding.Codes and.st:Lucie Countv,Amendrhents: The f6lldwing.t uildirig permit i ppiicatioris ar,`e exernOt from undergo ng•a full.concurrency review:,room additions; accessory structures,:swiniming pools,fentes;,walls,,signs,scree6"ro6nis and accessory uses io another non-residential use- W"AR.NING TGOWNER:Your failure:to Record:a Notice.of Co mmeocernLant;may resuitin.paying'twice;for improvements to your grope."rty A.Natice of Commencement must be,recardec! in fhe public reeords:of-St.. Lucie County and:posted:on the j.absite'before the-first,inspection:,if you:intend to obtain financing,consult with:lender`or'an:attorne :before cornmencin 'work,or recordin our,Notice of.Commencement. Signature of Owner/Lessee/Contractor as Agent.for Owner STATE OF.FLO. A COUNTY OF - Swor to(or affix ed)and subscribed before me of R. Physical Presence°or Online Notarisation this,, day af` A,,L_ ,20A.1.by !!me o person;making stateme. Personally Known OR°Produced Identification. `type 0f'Jdentification Produced f SignaYur of Notaryftblic=State,of Flarida'Y W,Coriiitiission No g4S :(Seal) _ _. wry PuMic4taite ut-F'o,ic,a . 5ti�phan+e.M'Todc Miy.Commssion G.G 9g580G. Expu'sa.01t0i812024 REVIEWS: FRQNT ZONING $UPERVIS,OR' PLANS VEGETATION' .SEA TURTLE MANGROVE; _. COUNTER REVIEW 'REVIEW REVIEW REVIEW` REVIEW REVIEW RECEIVED, , DATE ev - :COi1lIRLETED , .