HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
v
L Building Permit Application
Planning and Developmen t Services
Building and Code Regulation Division Commercial Residential x
2300 Virginia Avenue, Fort Pierre FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 5602 Paleo Pines Circle Fort Pierce, FL 34951
Property Tax ID 4: Lot No.
Site Plan Name: Block No.
Project Name: Smith Residence
DETAILED DESCRIPTION OF WORK:
INSTALLATION OF SOLAR PV SYSTEM TO ROOFTOP
New Electrical Meter Second Electrical Meter (Affidavit required)
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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 Sprinklers
_ _ _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ V,IL�L Utilities: _Sewer _Septic BuildingHeight:
OWNER/LESSEE: ! CC NOTRACTOR:
Name Tyrone Smith Narne: URBAN SOLAR GROUPIMICHAEL VERGONA
Address: 5602 Paleo Pines circle Company: URBAN SOLAR GROUP
City: Fort Pierce State: FL Address: 990 S ROGERS CIR STE 4
Zip Code: 34951 Fax: City: BOCA RATON, State: FL
Phone No. 772-519-3822 Zip Code:33487 Fax:
E-Mail: Tyronesmith87@9mail.com Phone No 5616092664
Fill in fee simple Title Holder on next page ( if different E-Ma it permittinoDurbansolar.com
from the Owner listed above) State or County License CVC56948
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H value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
tl value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:--_----___
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:--_—
City: _--__--- State: —_
Zip: _ — Phone_-- --_
City: ___ State: _
Zip: _ Phone:—_ _---
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: __Not Applicable
Name:
Address: _
Address:
City:---- ----_
CRY:
Zip. _--- Phone:_-----
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application Is hereby made to obtain a permit to do the work and Installation as Indicated.
I certlfy that no work or Installation has commenced prior to the Issuanceof a permit.
St. Lucie County makes no representation that Is granting a ppeermit will authorize the permit holder to build the subject structure
which Is In conflict with any applicable Home Owners Assodation bylaws
rules, or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and revlewyour deed for any restrictions which may apply.
In consideration of the grantingof 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 attorneybefore commencing work or recording our Notice of Commencement.
Slgnature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me of %C Physical Presence or Online Notarization
this I? dayof 2021 by
Mi
Name of person making sta ent.
Personally Known )0 OR Produced Identification
Type of Identification Produced
(Signature of N tary - State of Florida
Commission NO.4i+II3906 (Seal) 3'•• VICTORIAWAGNER
o.
" MY COMMISSION#HH 113906
EXPIRES: April 5, 2025
Bonded Thru Notary Public Undowriters
:T' Y6sePR•
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