HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1/10/2021 Permit Number:
c51r.
O
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:
Address: 7740 Greenbrier Circle
Property Tax ID #: 3322-700-0016-000-2
Site Plan Name:
Project Name: Warden
DETAILED DESCRIPTION OF WORK:
Solar Pool Heating System
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Lot No. 11
Block No.
Additional work to be performed under this permit— check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Pond
_Electric _Plumbing _Sprinklers _Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 5,700.00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Steven Warden
Name: Erik F. DeLaney
Address: 7740 Greenbrier Circle
Company: Climatic Solar Corporation
City: Port Saint Lucie State: _
Zip Code: 34986 Fax:
Phone No. 330-559-3171
Address: 650 2nd Lane
City: Vero Beach State: FL
Zip Code: 32962 Fax:
Phone No 772-567-3104
E-Mail: swarden5l@gmaii.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
If value of consfmrtinn !� -icnn.........,.
E-Mail support@climaticsolar.com
State or County License CVC56671
v..nnencemen[ is regnlrea.
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: _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
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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and post d on the job ' e before the first inspection. If you intend to obtain financing, consult
with lender or an att for mencin work or recordin our Notice o om enc nt.
Signat e o w er/ e C t acto as Agent for Owner Signature Cp6t r
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Inaian PW.r COUNTY OF InaianR r
Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of
Physical Presence
or —online Notarization Physical Presence or_Online Notarization
this day of
_ 2020 by this _ day of 2020 by
Name of person making statement. Name of person making statement.
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification
Produced Type of Identification
P oduced
Signature of Nota u ic- State of Florida )
(ignature of Not blic-Stateof Florida )
I Hak4h S
Commission No. II I
NotaryPubllc C
S ommission No. 11 y'� Hab{phShod
State of Florl a I) Notary
Public
r HH3 84'3 •r S State of Florida
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COUNTER REVIEW
REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
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