HomeMy WebLinkAboutAPPLICATION - HENRYAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
SA. LU C�Lr
Lb6 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: 5515 PALM DR FORT PIERCE, FL 34982
Property Tax ID #: 3402-609-0133-000-3 Lot No. 35
Site Plan Name: Block No. 55
Project Name: DUANE HENRY
DETAILED DESCRIPTION OF WORk:
ROOF MOUNTED SOLAR PV SYSTEM INSTALLATION - 18.72 KW
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
Mechanical _Gas Tank _Gas Piping _Shutters _
Electric _Plumbing _Sprinklers _Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 49,608.00 Utilities: Sewer
Windows/Doors _Pond
Roof Pitch
_Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Duane Henry
Name: NORMAN E PURKEY
Address: 5515 Palm Drive
Company: SOLAR BEAR LLC
City: Fort Pierce State: Fl
Zip Code: 34982 Fax:
Phone No. (443) 506-8147
Address:4091 AMTC CENTER DR
City: CLEARWATER State: FL
Zip Code: 33764 Fax:
Phone No727-471-7442
E-Mail: Dhenryl039@aol.com
Fill In fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail BRITTANY@OURSOLARBEAR.CG
State or County LicenseEC13006630
IT value or conscrucuon is ow or more, a K6LUKDEo Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION
(IEN 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:
1 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 priorto 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 posted on the jobsite before the first inspection. If you intend to obtain financing, consult
lender or an attorney
ttorne before commencin work or recording our Notice of Commencement.
`with
_1�ldt^-- -Ciao
Signature of Own ee/Contractor as Agentfor Owner
STATE OF FLORIDA
COUNTY OF _J)V J&S
Sworn to (or affirnnedj and subscribed before me of Physical Presence or _ Online Notarization
this 2,day of 20 ZL by
�y�(�fMh.n �flWl.l�
Name of person making stateme t.
Personally Known _X_OR Produced Identification
Type of Identifi - n Produced
(51 ature of Notary Public -State of Florida) t Joseph Trbou
Notary Public
Commission No R01177,70 (Seal) -StateofFlorida
"• = Comm# HHOM7
Expires 12/7/2024
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
ECEIVEDETED
L