HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
S n UJ-.GLls :
Planning and Development Services
Building Permit Application
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial
CBDG Funding
PERMIT APPLICATION FOR: Install Solar PV Panels
Residential X
Address: 4801 Snail Kite Ln, Fort Pierce, FL 34951
Property Tax ID #: 1418-122-0015-00019 Lot No.
Site Plan Name: Fort Pirerce Block No.
Project Name: David Harris
Install Solar PV Panels
New Electrical Meter NA Second Electrical Meter NA (Affidavit required)
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: 0 Sq. Ft. of First Floor: 0
Cost of Construction: $ 46583.00 Utilities: —Sewer _ Septic Building Height: NA
Name David and Sharon Harris
Address: 4801 Snail Kite Ln.
City: Fort Pierce State: R
Zip Code: 34951 Fax:
Phone No. E-
ntail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: Raymond J Mead
Company: LSCllnc.
Address: 300 Bryan Dairy Rd- Ste 400
City: Largo state: FL _---
Zip Code: 33777 Fax:
Phone No 727-346-5509
E-Mail Rich Burg(d)_USPermit.net
State or County License CVC056656
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.
�,UPPLEMENTAIL CONSTRUCTION LIEN
DESIGNER/ENGINEER: -,X_ Not Applic
Name:
Address:
City: State: _
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address: T
City:
Zip: Phone:
-X Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
X Not Applicable
State:
XNot Applicable
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 conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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 jobsite before the first inspection. If you intend to obtain financing, consult
with Ipr►riPr Ar an attn Yl]k)\I knfnrr� r.,.v, .,,.,r �i. , �1. - _J: _ .
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Signature of Contractor - or - Owner Builder as applicable
STATE OF FLORIDA
COUNTY OF ! 1 D S
Sworn to (or affirmed) and subscribed before me of Y Physical Presence or Online Notarization
this ii;�-_ day of n iA • 20_2:Z-by
Name of person making statement.
Personally Known X OR Produced Identification
Type of Identification Produced
(Signature of Notary Public- State of Florida)
Commission No. (Seal)
J'
state of Florida
'4� Nota:Ph
r° ThanPMy Con GG 975932
4or °aExpir/2024
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