HomeMy WebLinkAboutSmithDavidPVPacketAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: q_- �� _OOQ I Permit Number:
. _.�.__ ......_......._:.alb
COUNTY
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Building Permit Application
Residential
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: S n\4 Cc ` Q G TC.\
Property Tax ID#: y`i -- 0 -tp) rC)0o—a
Site Plan Name: !Jav 1 Cl k
Project Name:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Commercial
Lot No. A
Block No.
Additional work to be performed under this permit —check all that apply:
_Mechanical Gas Tank Gas Piping _ Shutters Windows/Doors
XElectric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 6,21 15G 0 C
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: i CONTRACTOR:
Namev q
Address: T 2pAf P 1gy
City: 1Ao.k'C.'rn 5or� 51�aState:
Zip Code: 3 L{ `I J �J Fax:
Phone No... �a sl_5 9 3D, [„
E-Mail:
Fill in fee simple Title Folder on next page ( if different
from the Owner listed above)
Name: i lc'-C, Q
Company:'So ll, 5+r E e; r- S S
City: _—Llc.me. State: F(_
Zip Code: -� q 1) %"� 't bl� n � L
Phone No aka�,
E-Mail
State or County License Dj
If value of construction is $2500 or more, a RECORDED Notice of Commencement Is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIG
Name:_
Address;
NGINEER: — Not Applicable
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address;
City: State:
Zip: Phone:_
BONDING COMPANY: Not Applicable
Name:_
Address:
City:_
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 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
18.t�U� i
Signature of Owner/ Lessee n ractor as gent for Owner Signature of Conf r/License Holder
STATE OF FLORIDA I STATE OF FLORIDA
COUNTY OF Sr COUNTY OF _ ` -T
The forgoing instrument as acl nowledged before me
this day of S{ e—'n e,C 20s3 by
Name of person making statement.
rsonally Known` OR Produced Identification
Produced
(Signature of Notary P li)State o Iorida) f
Commission No.Uv0
Zar!t� Notary Public State of
@� Wirnhorh, I ama
REVIEWS FRONT
COUNTER
DATE
RECEIVED _
DATE
COMPLETED —
The for oing instrume t was acknowledged before me
this day of e 20� by
Name of person making statement.
ersonally Know OR Produced Identification
Type o##de�ication
Produced
(Signature of Notary P�blic} State ofr�fdl
-`'
C//�l� Notary Public State
ssion No.CC- f I) Kimberly Large
! ExCommiasicr0 23Expiroa 12l28i2023
VEGETATION I SEA TURTLE I MANGROVE
REVIEW REVIEW REVIEW
752
SOLAR ENERGY SYSTEMS
An Energy Management Company www.solarenergysystei
1 160 Smallwood Ave. Florida State Certified Sol:
Ft. Pierce, Florida 34982 Martin Co. Indian River Co.
772-464-2663 7722-288-0442 772-562-8999
NAME
I 'kV, d <� .4A
ADDRESS CITY
SPECIFICATIONS: Solar Energy Systems offers to furnish and install:
VGrid-Tie wlback-up CI Stand Alone
System Size - KW
AC Requirements: C7 120 V 0 240 V 0 208 V 3PH
Array Mount Type: r7 Flush 0 Tilt
Roof Type: 0 Shingle O Flat Tile 0 BBL Tile Type
0 Metal Type 0 Ground
0 Single Story 0 2 Story Li Lift Required
Name of Utility Company: re111
Sketch of Roof Area
,SES Gold Warranty
• 25 Year Product Warranty
• 25 Year Performance Warranty
• 25 Year Labor Warranty
Indusrtry'v Best Warranty
ESTIMATE and PROPOSAI
infosolarenergyfl@ l:mail,corn
Contractor #CVC056637
State
1-800-330-7657 DATE 20
PHONE
CELL
E-MAIL
S MIT ZIPCODE a
17 BACK UP GENERATOR
l7 SOLAR: ELECTRIC SYSTEM
ELECTRICAL INFO
Location of Breaker Panel e
Model # of Breakers C
# of Empty Slots Available_
Distance to Solar Array
Clear Attic Access: [V `Yes 0 No
MAIN BREAKER SIZE I I MPS
NOTES:
I r,s-hr I l a i S"1 NU'Q cell -Sola
Monthly Loan Payment
*Increased Mouthty
Loan Payum"
If 26% is not paid
down on month IS
Back-up Info If Applicable: 12 Battery
# of days Back -Up Requested
Battery Mfr. (A) F t r Pr 0 7 t— ,%7
C3 Generator
Battery Location: O Outdoor ID Indoor
INSTALLATION I understand that this is only an estimated date, and that I will be contacted prior to this date to schedule actual Submitted By:
DATE Installation.
CuxlumcrCan NuyAt'115IsPrlceUnlil;(DATE) Building
Contact: phone t
Contractor;
We hereby propose to furnish labor & materials - Complete installation to existing premises in accordance wish above -specifications, for the sum ul-
TOTAL DOLLARS $
With payments to be made as follows 71 DEPOSIT $ _ O BALANCE $ JePONCOMPLETION O TO BE FINANCED
All system components meet FSEC standards. All work is to be completed in a workman] ike manner according to standard practices. Any aheratinn ur deviation from above sredficatinns involving extra costs, Nill he
only upon written orders, and wI1I become an extra charge over and above the estimate, All agreements are contingent upon strikes, acddents or delays beyond our control.
The above prices, specifications and conditions are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above.
Payments not made upon completion subject to late fees after 10 bays.
DATE
(CUSTOMER'S SIGNATURE)
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�� - s CUSTOSMEMBER
I ER; WI[ITE OFFICE: PINK FPL FLAB NUM
BBi • #r• PARTICIPATING INSTAL.LER:MANII.LA FLGRInA
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