HomeMy WebLinkAboutBUILDING PERMIT APPAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
< ` LLL LLI.I
c= s A Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: LSCI INC
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Address: 7506 SAN CARLOS AVE FT PIERCE, FL 34951 - 2168
Property Tax ID #: 1301-601-0135-000-7 Lot No. 6
Site Plan Name: Te'Auna L Cross Block No. 8
Project Name: CROSS PV
DETA
INSTALLING SOLAR PHOTOVOLTAIC SYSTEM
New Electrical Meter Second Electrical Meter
�L£ONS'TRUCTION,INFORMATIPN,,
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _. Shutters _ Windows/Doors Pond
X Electric _ Plumbing _ Sprinklers -_ Generator — Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 22,644.00 Utilities: --Sewer — Septic Building Height:
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OWNER_..LESSiEE: , _-- -_ NTR .., _
Name TE AAUNA GROSS Name: RAYMOND MEAD
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Address: 7506 SAN CARLOS AVE Company: LSCI INC.
City: FORT PIERCE State: _ Address: 7300 BRYAN DAIRY RD. STTE 400
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Zip Code: 34951 Fax: City: SEMINOLE State: FL
Phone No. 1 (954) 461-9366 Zip Code: 33777 Fax:
E-Mail: TEAUNA-CROSS@YAHOO.COM Phone No 727-571-4141
Fill in fee simple Title Holder on next page ( if different E-Mail PERMITS@SUNTECSOLARENERGY.COM
from the Owner listed above) State or County License CVC056656
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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.
, DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable
_
Name: MINDYNICOLE Name:
Address: 5700 LAKENORTH RD SUITE 211 I Address:
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City: GREENACERS State: FLI City: State:
Phone
Zip: 33463 Zip: Phone:
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FEE SIMPLE TITLE HOLDER: _ Not Applicable ( BONDING COMPANY: Applicable —
_Not
i 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.
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 Home Owners Association
your 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 commencjng work or re -cording r Notice of Commencement.
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Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF PINELLAS COUNTY OF PINELLAS
Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of
X Physical Presence or Online Notarization x _ Physical Presence or Online Notarization
this 7 day of SEPTEMEBER, 2021 by th1S 7 day Of SEPTEMBER 2021 by
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RAYMOND MEAD RAYMOND MEAD
Name of person making statement. Name of person making statement.
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Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Type of Identification
Pro uced - Produce
(Signature o Not (Signature of Notary Public- State F14 ' }
Act Notary Public State of Florida �q NoPublic State of ti
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Commission No. Thang Phu ¢cP��� Commission No. l- aVy Commission GG 9Y5 > Comm ssibh GG 875932 `!� xpiros 04/OS/?Ob/ Expires 04/05/2024
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