HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I_t ` 3Q -;4U��� Permit Number:
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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
PERMITTYPE: ' )01r-I (0\4
PROPOSED IMPROVEMENT LOCATION:
Address: r YC F l-- :S -
Property Tax ID #: 5(31 -)C3'-A 000 ! OQCG -1 Lot No.
Site Plan Name: G: a, ( o 11 Block No.
Project Name: f
DETAILED DESCRIPTION OF WORK., 1
CONSTRUCTION INFORMATION -
Additional work to be performed under this permit- check all that apply:
—Mechanical — Gas Tank _ Gas Piping — Shutters ____ Windows/Doors
� Electric ^ Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $
Sq. Ft. of First Floor:
Utilities: —Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name l
Address: "1 Ql ,�CJGL
Name: z�a ct
Company: �cy�Clr Ln eSY7S
„SVS
Address:
City: G State: F IL
Zip Code: Fax:
Phone No. �1 } S
City: F� per ' r Stater
Zip Code: 3 �9� Fax: - 1 Dlq to(-3)q�
E-Mail:
! -_
Phone No L4 61-1 a (0
E-Mail Sd f G ( e �' C } c ` : ulz ,
Fill in fee simple Title Holder on next page (if different
State or County License
from the Owner listed above)
ii veeue yr wnstrucrion is :�cSuu or more, a KtLUKUtU Notice of Commencement 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:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
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
is in
which 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 IMPROYEMENTS TO YOUR PROPERTY, A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
54 Q),r—
Signature of Owner/ Lessee n ractor as gent for Owner Signature of Cont` r/License Bolder
STATE OF FLORID STATE OF FLORIDA
COUNTY OF �T �_Q C I e, COUNTY OF ST �--UC 1
The far ping instrument was acknowledged before me The forgoing instrument was acknowledged before me
this of .120� this �G dlay of _ _ , 20,�( by
,cQday Iby `NCA
r
-1 1 c� C 1( l�cl� C Z
Name of person making statement. Name of person making statement. t
a ry —� $
ersonally Kno OR Produced Identifica 4 ri onally Kn )`n'� OR Produced Identificati $
Type ofl entification c Type of Identificationp �,v
Produced Produced ;5
� M
��N
Z, E
4
WW a.�s.x
(Signature of Notary Pu is State of Florida) z Y � w (Signature of Notary P b 'c- State of Florida j
Commission No. ti�l�� ��'�]� (Seal).•�'c Commission No. ��� `��-1�— (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED_
DATE
COMPLETED
ev. 2%7[JS _.
DocuSign Envelope ID: BB67E1A3-DB79-4071-8903-E365C5763247
SOLAR ENERGY SYSTEMS ESTIMATE and PROPOSAI
An Energy Management Company www.solarenergysystemsfl.com infosolarenergyft@gmail.eom
60 Smallwood Ave. Florida State Certified Solar Contractor #CVC056637
Ft. Pierce, Florida 34982 Martin Co. Indian River Co. state
10 - a 6 Q
772-464-2663 772-288-0442 772-562-8999 1-800-330.7657 DATE 20
NAME PHONE C*ELLL� �^-�
4. P,-y / v/ 0 G f- Q
Gp+eq E-MAIL t
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eV Q"C'N err
ADDRESS CITY STATE Z]PCODE #
e
1
t� oL
SPECIFICATIONS: Solar Energy Systems offers to furnish and install: 7) BACK-UP GENERATOR
. " LAR ELECTRIC SYSTEM
rid -Tie 171 Grid -Tie w/back-up 0 Stand Alone
ELECTRICAL INFO
System Size. •_ _ KW
Location of Breaker Panel "{/ I rjl 0( &<- W-1 clC'gef)
Model # of Breakers_ _
AC Requirements: a-T250 V 2-Z4-0-V 7 208 V 3PH
_ rr
# of Empty Slots Available _ &J, jga�ZL W �f
Array Mount Type: Flush 0 Tilt
Distance to Solar Array_ Pt
Roof Type: ❑ Shingle O Flat Tile 177 BBL Tile Type _
Metal Type S S ❑ Ground
Clear Attic Access: fe" rea F) No
MAIN BREAKER SIZE AMPS
Single Story 2 Story n Lift Required
Name of Utility Company: NOTES: t�K W - t� �3a ar C�� dL't
�n �/� lSft�K— a
X 4,sC
. i &L _ 4, 1 oo , M
t jjj I .lSO
elce�r� L-$ ! '�
Monthly Loan Payment
`Increased Monthly
Loan Payments
If 26% is not paid
down on month 18
-Sketch of Roof Area
SES Gold Warranty Back-up Info If Applicable: Battery ❑ Generator
• 25 Year Product Warranty # of days Back -Up Requested t _
• 25 Year Performance Warranty C�Z
���e25 Year Labor Warranty Battery Mfr.
Indusrtry's Best Warranty gAa j C l O
Battery Location: ❑ Outdoor �oor
INSTALLATION
I understand that this is only an estimated date, and that I will be contacted prior to this date to schedule actual
° I C k n ,
Syhsgittc Ry:71
DATE
installation.
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RA
Customer Can Buy At This PrieUntil:(DATE)
Ruildin
Contact:
Phone#
Contractor•
We hereby propose to furnish labor & materials • Complete Installation to existing premises In accordance with above specifications, for the sum or.-
TOTAL- _ __. DOLLARS$ � yI
With payments to be made as follows W EPOSIT S ® a �3 ALANC£ $_ .� 300, t:ia M<PONCOMPLETION C7 TO BE FINANCED
All system Components nest FSEC stan(ards, All work is to be comptetad In a workmanlike manner according to standard practices. Any alteration or deviation from above specifications involving extra costs, will he executed
only upon written orders, and wig become 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 made upon completion subjeeclaishit6tuWfiler 10 days.
(- JST01%1FR'S SIGNATURE) (SPOUSE'S SIGNATURE)
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• r CUS'It NII'R WHITF OFFA;E I'INK INSTALLER: ,MAMLLA FLORIDA
PARTICIPATING n,K�
ggg 1_T�J�� INDEPENDENT
�. CONTRACTOR Res I S
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