HomeMy WebLinkAboutBuilding permit appALL 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
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PERMIT APPLICATION FOR: Building
PROPOSED IMPROVEMENT LOCATION:
Address:
WHITE CITY S/D 09 36 40 N 105 FTOF S 390 FT OF W 97.23FT OF E 900.07 FT OF LOTS 222 AND 223 (0.23 AC) (MAP34/09S) (OR
Legal Description:
Property Tax ID #: 3403-502-0267-000-6
Lot No.222/223
Site Plan Name:
Block No.
Project Name: Clyde Heffelfinger
Setbacks Front Back: Right Side:
Left Side:
DETAILED DESCRIPTION OF WORK:
I
Solar PV System Roof Mount & Interconnection
CONSTRUCTION INFORMATION:
r orme un er t (s permit— c ec
Additional work to ffGasTank
0HVAC Gas Piping
a app y:
_ Shutters Windows/Doors
11 Electric 0 Plumbing Sprinklers
11 Generator E]Roof Roof pitch
Total Sq. Ft of Construction::
S Ft. of First Floor:
7
ElSeptic
Cost of Construction: $ / Utilities
Sewer Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameClyde Heffelfinger
Name: Rafael Angel Gonzalez Mendoza
Company: Go Solar Power LLC
Address:1008 Echo St
Address: 933 clint moore rd
City: fort pierce State:FL
City: boca raton State: FI
Zip Code: 34982 Fax:
Phone No.7723701593
Zip Code: 33487 Fax:
E-Mail:Cbheff@comcast.net
Phone No. 561-228-4483
E-Mail: Jackson@gosolarpower.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State or County License: CVC56962
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name: Clyde Heffelfinger
Name: Rafael Angel Gonzalez Mendoza
Address:
Address: fooSEchoSt
City: fort pierce State:
City: bocaraton State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address: 933 clint moore rd
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 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 workX_recording your Notice of Commencement.
Signature o r Lessee/Contractor as Agent for Owner
ure o ontractor License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF St Lucie
COUNTY OF St Lucie
The fgrgoing instru nt s a cnowledged,bpfore me
this � day of 20 P4 y
The f'rgoing instrume t was acknowledged before me
this day of 2( oZAy
Clyde Heffelflnger
Rafael Angel Gonzalez Mendoza
Name of perso�,�ing statement
Name of person maki atement
Personally Known V OR Produced Identification
Personally Known Produced Identification
Type of Identification
Type of identification
Produced
Produced
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17