HomeMy WebLinkAboutPetersonPVPacketAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: J/- Permit Number:
- J
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 d
PERMITTYPE: --
PROPOSED IMPROVEMENT LOCATION:
Address:.-) .5
Property Tax ID #:
Site Plan Name:
Project Name: _
�CC. �C e.C�r�nfl
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
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o y
Additional work to be performed under this permit -check all that apply:
Mechanical ` Gas Tank _ Gas Piping _ Shutters
`3 Electric _ Plumbing Sprinklers Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor: —
Cost of Construction: $ _ r 5� ) Q C') Utilities: —Sewer _Septic
Lot No. I
Block No.
Windows/Doors
Roof Pitch
Building Height:
OWN ER/LESSEE:
CONTRACTOR:
Name_. k O 1dG eJ f.''Sc� _.._
Name: c r+ riG
Company: So b r' 6n e re.,S
Address: e
City: 5 T L u (:,i c State: FL
Address: .--_,t (o U bra 5c., ( i c_o tL {4 SiX_._.
Zip Code: t{' `_��-Fax:
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City: �� I ,pf � iC_,State
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Phone Na.
_
Zip Code: �ii��- Fax:
E-Mail:
Phone No gt-k
Fill in fee simple Title Holder on next page (if different
E-Mall 5010 ,
from the Owner listed above)
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State or County License C~ b
a, rw,..c wwlmai ut«u,J ,a .?zDuu or more, a KummPtu malice of Lommencement is required.
If value of HVAC 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:
PEE SIMPLE TITLE HOLDER: Not Applicable
--4
BONDING COMPANY: � Not Applicable
Name:
Name:
Address:
Address:
SOLAR ENERGY SYSTEMS
An Energy Management Company
ESTIMATE and PROPOSAL
O1160 Smallwood Ave. Florida State Certified Solar Contractor #CVC056637
Ft. Pierce, Florida 34982 Martin Co. Indian River Co.
State
772-464-2663 772-288-0442 772-562-8999
1-800-330-7657 DATE
NAME
PHONE
CELL
E-MAII.
ADDRESS
CITY
STATE
ZIP ODE
REF#
SPECIFICATIONS: Solar Energy Systems offers to famish and install: f7 B,�CK-UP GENERATOR
0 'SOLAR ELECTRIC SYSTEM
17'Grid-Tie 0 Grid -Tie w/back-up 0 Stand Alone ELECTRICAL INFO
System Size, _-_ - KW
AC Requirements: a '120 V rl 240 V 0 208 V 3PH
Array Mount Type: -3 Flush 0 Tilt
Roof Type: 17 Shingle 0 Flat Tile 0 BBL Tile
0 Cedar Shake 0"Metal 0 Ground
Story n 2 Story rl Lift Required
Location of Breaker Panel
Model # of Breakers
# of Empty Slots Available _
Distance to Solar Array
Clear Attic Access, 0-Yes
Name of Utility Company: I NOTES:
0 No
Pt.ti�
1. j f ti 7
` i —1 t
i [LLE
uL t , 11o. C
Sketch of Roof Area I F: ! n r y
NOTICE of CANCELLATION
You the buyer, may cancel this transaction at anytime prior to midnight of the third business day after the date of this
transaction. Thereafter, this contract cannot be canceled and deposit will be forfeited. This contract constitutes the full
and only agreement between Parties, there being no promises, agreements or understandings, written or oral, except as
herein set forth. This contract is subject to acceptance or rejection by the management of SOLAR ENERGY SYSTEMS.
See the attached notice of cancellation form for an explanation of this right.
I HEREBY CANCEL THIS TRANSACTIONMAWrN
_
INSTALLATION
I understand that this Is onlyan estimated date, and. that I will be contacted prior to this date to schedule actual
Submlitted By:
DATE
installation
Customer Can Buy At this Price Until: (DATE)
Building Contact:
Phone k
Contractor
We hereby propose to furnish labor & materials - Complete installation to existing premises in accordance with above specifications, for the sum of:
TOTAL— DOLLARS(
With Payments to be made as (allows 011EPOSIT S O BALANCE $_ _ o UPON COMPLETION I *ro BE FINANCED
All system components meet FSEC standards. All work is to he Completed in a workmanlike manner according to standard practices. Any alteration or deviation from above specifications involving extra costs, will be executed
only upon written orders, and will became an extra charge over and above the estimate. All agreements are contingent upon strikes, accidents 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 trade. upon completiou subject to late fees after 10 days.
DATE (CUSTOi/IEIr5 SIGNATURE) (SPOUSE'S SIGNATURE)
MF,MlBER !
ffs. . t.UsI0MISR. WHITE ��� OFFICE- PINK PARTICIPATING CNi, INSTALLER: MANILLA FOq@190&
INUEPE DENT roue dempow assarrR