HomeMy WebLinkAboutPERMITING AUTHORIZATION FORM• rban Olar 990 S Rogers Cir, Suite 4
Boca Raton, FL 33487
Florida License: # CVC5694$ (888) 38-SOLAR
info@urbansolar.com
# EC13005324
PERMITTING AUTHORIZATION FORM
OWNER OF THE PROPERTY LOCATED AT ADDRESS:
8101 Bayard RD Fort Pierce, FL 34951
DO HEREBY AUTHORIZE THE PERMITTING DEPARTMENT OF URBAN SOLAR GROUP, (KIMANDY
LAWRENCE) TO SIGN AND APPLY FOR A BUILDING PERMIT ON MY BEHALF. THIS AUTHORIZATION IS
VALID ONLY FOR THE PURPOSE OF OBTAINING A PERMIT TO PERFORM THE SOLAR INSTALLATION WORK
CONTRACTED FOR BY AND BETWEEN OWNER AND URBAN SOLAR GROUP. THE OT%Wi'iiMERMIT(S) WHICH
MAY BE APPLIED FOR UNDER THE TERMS OF THIS LETTER ARE THOSE WHICH TAC Ad"4GfiiTY HAVING
JURID€SCTION (CITY OR COUNTY) DEEM(S) NECESSARY UNDER THE CURRENT FLORIDA BUILDING CODE,
GIVEN THE SCOPE OF WORK CONTRACT FOR. URBAN SOLAR GROUP WILL BE RESPONSIBLE FOR ANY
AND ALL FEE ASSOCIATED WITH THIS PERMIT APPLICATION. THE AUTHORIZATION WILL REMAIN VALID
UNTIL SUCH PERMIT(S) IS/ARE ISSUED BY THE RESPECTIVE BUILDING DEPARTMENT, OR UNTIL ONE
HUNDRED AND TWENTY (120) CALENDAR DAYS FROM THE DATE LISTED BELOW HAVE TRANSPIRED,
WHICHEVER IS LESS.
HOMEOWNER SIGNATURE
NOTARY AS TO OWNER
PRINTED NAME
7b���
DATE
Sworn and subscribed before me this day,
of , 20and [ I is personally known or
[ ] produced as identification.
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