HomeMy WebLinkAboutBuilding Permit ApplicationTSP113411
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: _
L U CC,-UL�,- - {
Building Permit Application
Planning and Development Services "
Building and Code Regulation Division Commercial Residential J�
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED_ IMPROVEMENT LOCATION:
Address: 181 NE Caprona AVE Port St Lucie, FL 34983
Property Tax ID #: 3419-530-0229-000-4 _ _ Lot No. 7
Site Plan Name: Block No.
Project Name: Herrera PV Solar
I DETAILED DESCRIPTION OF WORK: -
PV Solar InstallationNew 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 Windows/Doors Pond
Electric Plumbing _ Sprinklers -_ Generator Roof Pitch
Total Sq. Ft of Construction: _ Sq. Ft. of First Floor:
Cost of Construction: $ 69000 _ Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
Name Jairo J Herrera .
Address: 181 NE Ca rona AVE
City: Port t Lucie, state: FL
Zip Code: 34983 Fax:
Phone No. 305 607-1759
E-Mail: Jairoherrera32 hotmail.com_
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
I LUNTRACTUK:
Name:
Company: 'r
Add ress:q 0 i
City: Y- , %W) . State:
Zip Code: -_.3` -ILA I Fax: _
Phone No - C39 -3f2613L
E-Mail � 7 r• (Qri
State or County License ACC (i�'i y
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.
TSP113411
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNED/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name:
Name:_ _
Address:
Address:
City:
State:
City:
Zip: Phone
_ _ _ _
Zip:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
Citv:
Zip; Phone:_
Not Applicable
State:
Phone:
BONDING COMPANY: Not Applicable
Name: _
Address:
City:,
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 cordlilt with any applicable Rollie 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
with lender or an attorney before commencing work or recordin our Notice of Commencement.
Signatur Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF ls.
Sworn tg (or affirme ) and su scribed before me of _lam! Physical Presence or Online Notarization
this _Zr day of 20 ZZ by
Name of person making statement.
Personally Known / OR Produced Identification
Type of Identification Produced
(Signature ofp4otary Public- State of
Commission No. Rft IN Eby
da)0
��.••,rir'� +rye KRYSTAL RODRIGUEZ OTERO
(Seal) Notary P01ic-StO19 of Flar+de
*= Commission N HH 89764
MY Commission Expires
''°°►"° February M 2025
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