HomeMy WebLinkAboutWilcenski permit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number:
L LLLLL"
l'1�1J1a1���
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: 5102 Indian Bend Lane
Property Tax ID #: 1312-800-0013-000-1
Site Plan Name:
Project Name: Wilcenski
I DETAILED DESCRIPTION OF WORK:
Solar Pool
New Electrical Meter Second Electrical Meter
Lot No. 182
Block No.
CONSTRUCTION INFORMATION: --I
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: $ 4,900
_ Generator
Sq. Ft. of First Floor:
Windows/Doors Pond
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name William and Lilian Wilcenski
Name: Erik F, DeLaney
Address: 5102 Indian Bend Lane
Company: Climatic Solar Corporation
City: Fort Pierce State: _
Zip Code: 34951 Fax:
Phone No. 772-464-7465
Address: 650 2nd Lane
City: Vero Beach State: FL
Zip Code: 32962 Fax:
Phone No 772-567-3104
E-Mail: marose5001950@gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail sales@climaticsolar.com
State or County License CVC56671
-- ----- ----••--••-•• •� ----., ,,,.,, a n�wnv�u nuuce or wmmencement rs 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 TITLEHOLDER: _ Not Applicable
BONDING COMPANY: Applicable
Name:
_Not
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 is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may
structure. Please
restrict or prohibit such
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 post d on the job " e before the first inspection.
If you intend to obtain financing, consult
with lender or an att for mencin work or recordingour Notice*omnc
nt.
Signat e o w er/ e C t aco as Agent for Owner Signature Cpd
STATE OF FLORIDA
COUNTY OF�aen STATE OF FLORIDA
COUNTY OF mmenR�
Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of
Physical Presence
or Online Notarization � Physical Presence or Online Notarization
this day of �4PIC, ,.� �• 2024 by
this � day of SC (��� V 2020 by
Name of person making statement. Name of person making statement.
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification
Pr du Type of Identification
Produced
ignature of Notary P ic- State of FI�
Notary Public t�ignacure or Notary RubYo- State of Florida )
�Lt-1
Commission No.-qa I 1 �l 1 15 State of Florida `/ i ` HaW& Short
Cornm# Vommission No. j� ���j Notary Public
Expires 5/2s 25 a State of Florida
Comm# HH1
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MAAN ROVE
COUNTER REVIEW REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.