HomeMy WebLinkAboutSKM_C25821091017020 (2)ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
Residential xxxxxxxxx
PERMIT APPLICATION FOR: Building
PROPOSED IMPROVEMENT LOCATION:
Address: 110 Beach Ave Port Saint Lucie, FL 34952
Legal Description: RIVER PARK -UNIT 3- BLK 26 LOT 1 (MAP 34/22S) (OR 3725-1589)
Property Tax ID #: 3419-515-0158-000-8
Lot No.1
Site Plan Name:
Block No. 26
Project Name: David Flores
Setbacks Front _ Back: _ _ Right Side:
Left Side:
DETAILED DESCRIPTION OF WORK:
Solar PV System Roof Mount & Interconnection
CONSTRUCTION INFORMATION:
Additional work to b,eoerformed under this permit — c ec
HVAC Gas Tank Gas Piping
all apply:
_ Shutters ❑ Windows/Doors
Electric 0 Plumbing Sprinklers
11 Generator EIRoof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: S 42,248.32 Utilities:
Sq. Ft. of First Floor:
Sewer USeptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name David Flores
Name: Rafael Angel Gonzalez Mendoza
Company: Go Solar Power LLC
Address:110 Beach Ave
City: Port St Lucie State:FL
Address: 933 Clint Moore Rd
City: Boca Raton State, FI
Zip Code: 34952 Fax:
Phone No.772-207-9909
Zip Code: 33487 Fax:
E-M a i 1: Davidaflo440@gmai Lcom _
Phone No. 561-228-4483
E-Mail: Jackson@gosolarpower.com
Fill in fee simple Title Holder on next page (if different
State or County License: CVC56962
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of
Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
City: __
Zip: Phone:
BONDING COMPANY:
Name:
Address:
Citv:
Zip: Phone:
Not Applicable
Not Applicable
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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded 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 vour Notice of Commencement.
DAvid Flores
Signature of Owner/ Lessee/Contractor as Agent for
STATE OF FLORIDA
COUNTY OF st—ie
The forgoing instrument was ackn wledged before me
this day of �+ 20_ by
David Flores
Name of person mak,.ng statement
Personally Known OR Produced Identification
Type of Identification
Produced _
(Signature of Nota Public- State of Florida )
Commission No. yCi,Y aINotaryPublicStateof
Jackson Nash Mclr
'k My Commission HH 0
o c Expires 08/1112024
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DATE
RECEIVED
DATE
COMPLE
Rev.8/2/1 L:vo Notary Public State ofFloridE
Jackson Nash McInerney
r s My Commission HH 031240
�40i" L� Expires 0811112024
Holder
STATE OF FLORIDA
COUNTY OF St L.d.
The forgoing instrument was ack wledged before me
this -,�� day of � , 20� by
Rafael Gonzalez
Name of personp4king statement
Personally Known OR Produced Identification
Type of Identification
Produced
Si ure f Notary Public- State of Florida )
m slNo. ' s�Ya NoJ&eIPIJalicState ofFloridz
90 - 6 Jackson Nash McInerney
�y. My Commission HH 031240
u, +° Ex6res08/11/2024
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