HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll 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 Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Agtlress: auu vrc rUIL rIUIG6, rL J4yt5L
Property Tax ID #: 3402-609-0570-000-8
Site Plan Name:
Project Name: PERRY JAMES
RESIDENCE
DETAILED DESCRIPTION OF WORK:
INSTALLATION OF SOLAR PV SYSTEM TO ROOFTOP
New Electrical Meter Second Electrical
CONSTRUCTION INFORMATION:
(Affidavit required)
Lot No. 36
Block No. 67
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
URBAN SOLAR GROUP/ KIMANDY LAWRENCE EC13005324
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: —Sewer
_Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name PERRY JAMES
Name: MICHAEL VERGONA
Address: 6109 Palm DR
Company: URBAN SOLAR GROUP
- Fort Pierce
City: State: FL
Zip Code: 34982 Fax:
Phone No. 5616092664
-
Address: 990 S ROGERS CIR STE 4
City: BOCA RATON State: FL
Zip Code: 33487 Fax:
Phone No 5616092664
E-Mail: PERMITTING@URBANSOLAR.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-
Mail PERMITTING@URBANSOLAR.COM
State or County CVC56948
License CVC56948
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.
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: Applicable
Name:
_Not
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.
is in co %ctctawith any representation that
Association r elsauthorizear anpermit holder to build the d
or proohibit such
covenants that may restrict
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 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 'obsite before the first inspection. If you intend to obtain financing,
consult ith lender or an attorney �efore '
commencing work or recor your Notice of Commencement.
Signature Owner/ Lessee/Contractor as Agent for Owner
Signatur of Con for/Ucen er
STATE OF FLOF�pA
STATE OF FLORIDA
COUNTY OF {iQ�r�.t BM[k)
COUNTY OF pa IYY1 l e rig
S Byrn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Xl Physical Presence or Online Notarization
this_2- dayof DfC{rr;h 202.1 by
Physical Presence or Online Notarization
,r-
this Zday of DtYemis,.r.20?I by
MICHAEL VERGONA
MICHAEL VERGONA
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known X OR Produced Identification
Type of iFic ion P oduced
Type of Ident' ' nPgoduced
nat Otary Pu tc-
(Si f Notary Public-
::*'" CORRIE RIVETfE
Commission No. Wt OMMISSION#HH1
9
:•✓�_' CORRIE RIVETrE
I _
�o No. lly�Dy
.:(
EXPIRES: June28.2025
mission = �,�§gMMISSION#HH14&187
•. Bonded lnN Notary wdw
o; EXPIRES: June 28, 2025
ers `. orti P.
,��.....° Bonded Tlvu Notary PuNk Undeninteni'
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