HomeMy WebLinkAboutPermit Application - MolinaAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11 i'y Z Permit Number:
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P ° t ``I Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential i/
2300 Virginia Avenue, Fart Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
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Address: 6904 SANTA CLARA BLVD FORT PIERCE FL 34951
Property Tax ID #: 1301-611-0085-000-2 Lot No. 7
Site Plan Name: Block No. 105
Project Name: RUBEN MOLINA
DETAILED DESCRIPTION OF WORK:
ROOF MOUNTED SOLAR PV SYSTEM INSTALLATION - 11.52 KW
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 _Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 30,528.00 Utilities: Sewer
Windows/Doors _ Pond
Roof Pitch
_Septic Building Height:
OWMER/LESSEE-
CONT
CTOR,
Name RUBEN MOLINA
Name: NORMAN E PURKEY
Address: 6904 SANTA CLARA BLVD
Company: SOLAR BEAR LLC
City: FORT PIERCE State: _EL
Zip Code: 34951 Fax:
Phone No.
Address: 4091 AMTC CENTER DR
City: CLEARWATER State: FL
Zip Code: 33764 Fax:
Phone No 727-471-7442
E-Mail: IU SaCuwMoCrau 2u bu .nw: (.cam
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail JOET@ OURSOLARBEAR.COM
State or County LicenseEC13006630
IT Value or construction is 2SUU 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 C4NSTRUCTt4N LIEN LAW INFORMATION.
DESIGNER/ENGINEER: x Not Applicable
Name:
MORTGAGE COMPANY: x Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State: _
Zip; Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
BONDING COMPANY: x Not Applicable
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 certifythat 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,
accessary 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 attorneybefore commencin work or recording our Notice of Commencement.
Signature w er ontractorasAgentforowner
STATE OF FLORIDA
COUNTY OF PINELLAS
Sworn to (oraffirmed) and subscribed before me of —kvphysical Presence or Online Notarization
this 0-day of 20,.R(by
NORMAN PURKEY
Name of person making statement.
Personally Known --�, O/R Produced Identification
Type of Identificati Produced
(Sig atur f Notary Public -State of Florida)
rw Joseph Tribou
Notary Public, State of Florida
Commission No. MM 09 (Seal)FN%
My Commission Expires 12/07/2024
Commission No. HH 69907
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