HomeMy WebLinkAboutBuilding -Permit Application 2All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Sc'n Lll C-UI
Planning and Development Services
Permit Number:
Building Permit Application
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:
Residential X
Address: 7705 Lockwood DR Fort Pierce. FL 34951
Property Tax ID #l: 1301-603-0193-000-7 Lot No. 16
Site Plan Name: Block No. 23
Project Name
FORD RESIDENCE
DETAILED DESCRIPTION OF WORK:
INSTALLATION OF SOLAR PV SYSTEM TO ROOFTOP
New Electrical Meter Second Electrical Meter (Affidavit required)
I CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors _ Pond
Electric
Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ " N �
Sprinklers
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Richard P Ford;Maria V Ford
Name: URBAN SOLAR GROUP/MICHAEL VERGONA
Address: 7705 Lockwood DR
Company: URBAN SOLAR GROUP
City: FORT PIERCE State: FL
Zip Code: 34951 Fax:
Phone No, 5616092664
Address: 990 S ROGERS CIR STE 4
City: BOCA RATON, State: FL
Zip Code: 33487 Fax:
Phone No 5616092664
E-Mail: PERMITTING@URBANSOLAR.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail PERMITTING@URBANSOLAR.COM
State or County License CVC56948
it vawe or construction is ZDUU 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 commencing work or recording our Notice of Commencement.
Signiture of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF DA.IM 9-CaPil
Sworn to (or affirmed) and subscribed before me of NV/4Physical Presence or _ Online Notarization
this to— day of AAilili 20!04 by
//N a___
Name of person making statemeki
Personally Known _X__ OR Produced Identification
Typ of Identification Produced
(Signaturd of Notary Public- State of Florida )
Commission No. 145 00 (Seal) �'� Notary Public 91s12 of Flonoa
(JG'q
Stephanie M Todd
+� My Commseron Go 945900
1 Fxpues Ot/09/2024
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