HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8/23/2021 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 605 Beach Ave Port St. Lucie, FL 34952
Property Tax ID#: 3419-510-0177-000-2 Lot No. 12
Site Plan Name: Bosener Louis-Charles Block No.
Project Name: Bosener Louis-Charles
DETAILED DESCRIPTION OF WORK:
Installation of photo voltaic solar panels on rooftop. Line side tap.
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/Doors _Pond
X Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ $21,590.00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Bosener Louis-Charles Name: Cameron Christensen
Address: 605 Beach Ave Company: Momentum Solar
City: Port St. Lucie State: FL Address: 6210 Hoffner Ave Ste 100
Zip Code: 34952 Fax: City: Orlando State: FL
Phone No. 321-247-6073 E- Zip Code: 32822 Fax:
Mail: flpermits@momentumsolar.com Phone No 321-247-6073
Fill in fee simple Title Holder on next page (if different E-Mail flpermits@momentumsolar.com
from the Owner listed above) State or County License CVC57036
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: X Not Applicable
Name: Mina Makar Name: _
Address: 2 Star view Dr Address:
City: Hillsborough State: NJ City: State:
Zip: nR844 Phone 551-689-5068 Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: X 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 conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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.
Signature of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF St. Lucie
Sworn to(or affirmed)and subscribed before me of X Physical Presence or Online Notarization
this 23 day of August 2021 by
Cameron Christensen
Name of person making statement.
Personally Known X OR Produced Identification
Type of Identification Produced
Signature of Notary Public-State\o Florida)
��?" e KRISTINA SALGADO
Commission No. GG972215 (Seal) 2�' `o Commission#GG 972215
o= Expires July 21,2024
'_"OF F\- Bonded Thru Budget Notary Services
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