HomeMy WebLinkAboutJalil, Jose Building App.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 Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 7001 Deland AVE Fort Pierce, FL 34951
Property Tax ID q: 1301-612-0217-000-0
Site Plan Name:
Project Name
JALIL RESIDENCE
DETAILED DESCRIPTION OF WORK:
INSTALLATION OF SOLAR PV SYSTEM TO ROOFTOP
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
_Electric _Plumbing _Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ � , Z�
Generator
Sq. Ft. of First Floor:
Lot No. 11/12
Block No. 128
Windows/Doors _Pond
Roof Pitch
Utilities: —Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Jose D Jalil;Maria Del Carmen Jalil
Name: URBAN SOLAR GROUP/MICHAEL VERGONA
Address: 7001 Deland AVE
Company: URBAN SOLAR GROUP
City: FORT PIERCE State: FL
Zip Code: 34951 Fax:
Phone No. 5616092664
Address: 990 S ROGERS CIR STE 4
City: BOCA RATON, State: FL
Zip Code: 33487 Fax:
Phone No 5616092664
E-Mail: PERMITTING@URBANSOLAR.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail PERMITTING@URBANSOLAR.COM
State or County License CVC56948
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: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
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.
1 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 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 Y
Sworn to (or affirmed) and s bscribed before me of �O Physical Presence or Online Notarization
this �IMday ofl�gaj�I / .20� by
1' \ITN\(dJJ V9 r(6q(A,
Name of person making statement.
Personally Known L"OR Produced Identification
Type of Identification Pr uced
(Signature of Notary Pub Slate iff Florida )
0 Ad* AyCORRIERNETTE
Commission No. d (Seal) F MYCOMMISSION#HH 146481
EXPIRES: June 28, 2025
Bonded Ttuu Notary Public Underwdrera
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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