HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ! &x Permit Number:
P ' 0 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:
PROPOSED4MPROVEMENT LOCATON:
Address: 6009 PAPAYA DR FORT PIERCE, FL 34982
Property Tax ID #: 3402-61 G-0560-000-9 Lot No.28
Site Plan Name: Block No. 88
Project Name: DAWN GOYETTE
DET�11lfD DESCRIPTION OF WORK -
ROOF MOUNTED SOLAR PV SYSTEM INSTALLATION - 23.4 KW
New Electrical Meter Second Electrical Meter (Affidavit required)
f CONSTRUCTION INFQi MAPON: 1
Additional work to be performed under this permit —check all that apply:
Mechanical _Gas Tank _Gas Piping _Shutters
Electric _Plumbing _Sprinklers _Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 62,010.00 Utilities: Sewer
Windows/Doors _Pond
_ Roof Pitch
_Septic Building Height:
OWWEK&EWE:,
ca
ORr
Name DAWN GOYETTE
Name: NO
MAN E PURKEY
Address: 6009 PAPAYA DR
Company:
OLAR BEAR LLC
City: FORT PIERCE State: FL
Zip Code: 34982 Fax:
Phone No. 440-339-2074
Address: 4691
AMTC CENTER DR
City: CLE
Zip Code:-,ia764
Phone No
RWATER State: FL
Fax:
2727-47T 1-7442
E-mail: COYFTTFDM(1 .MAI . OM
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail JOET@ OURSOLAR BEAR.COM
State or County LlcenseEC13006630
„.e,ue Ui wnm°ucuun n cauu or more, a newxutu Nouce oT commencement Is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUS E-MENTAL CONSTRVMN UtN LAW 000 ;
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: Stater
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 qr 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.
A C. 42,3
Signature of Owner/ 1.90610"actor as Agent for Owner
STATE OF FLORIDA
COUNTY OF 42",Pda
Sworn to (or affirmed) and subscribed before me of Physical Presence or_ Online Notarization
this -lg_ day of 20s by
Name of person making stateme t.
Personally Known r/ OR Produced Identification
_
Type of Identification Produced
ign ture e Notary Public- State of Florida )
Commission No. /i!d-699A (Seal) Joseph ou
Notary Public, State of Florida
tat
My Commission Expires 12/07/2024
Commission No. HH W907
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DATE
RECEIVED
DATE
COMPLETED
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