HomeMy WebLinkAboutBuilding Permit ApplicationI
A
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �� 1 Permit Number:
Building Permit Appli
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
6- 13-1 11 a
CEIVED
OCT 3 0 2017
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at t e end of line
pmtment
Address: pt?g Arte
\-9c ►e4- G ��
of S-E Lu6e,
PL 3%_n%to
Legal Description: ` D"b IS
uD I
(Pb Lf1'S)
Loi-240 Co(� 342.3-2.519)
Property Tax ID #: g327-j00" 0OgS_ 000 - Li
Lot No. 4D
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
soLAA PAL Nam- g S� s`T�m
iaitionai worK to De
F]HVAC
11 Electric
errormea
unaer tnis permit- cnecK an
Tank ❑Gas Piping
Plumbing Sprinklers
apply: -
Shutters a Windows/Doors
Generator Roof
__Gas
I"1
Total Sq. Ft of Construction:
6�
Cost of Construction: $ ; �rJ (D acoL
S Ft. of First Floor: _
Utilities: Sewer Septic
Building Height:
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C®,NTR�C�T®,it: ��*
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Name '
00.y id. Y,o
Name: Robert Zrallack
Address: -16�p o G«2n ieC CiC
Company: Solar Energy Systems
Address: 160 Smallwood Avenue
City: WC-4 e State: ft-
Zip Code: _3L1clj_i(o Fax:
Phone No. 302- gNk- d5�1"1
E-Mail:
City: Fort Pierce State. FI
Zip Code: 34982 Fax: 772-466-7937
Phone No. 772-464-2663
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: vpsolarenergy@yahoo.com
State or County License: CVC056637 / 9057
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPP'LEMENTAI. CWNSrTR, '111®N LIIEfN LAW IN.F®RMAiI'®N:' U 1
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
_ Not Applicable
State:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY:
Name:
Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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, 1 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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded 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 recording
Lour Notice of Commencement.
qj:� I Gam-- ru_�L
s
_ Signature of Owner ssee/Agent Signatul of Contrac License older
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this,2=1��iay of OGiybol 20 Zby this Zoil lay of C) r-�1p ar- , 20 L by
Robert Zrallck 1 Robert Zrallack
(Name of person acknowledging) (Name of person acknowledging )
(Signature of Notary Public- St to of Florida) ( I nature of Notary Public- State of Florida )
Personally Known ✓ OR Produced Identification
Type of Identification Produced t" Marie Sarah Music
'WIflaNATAL DI IRI I!`
Commission No. 6F9 12131
Revised 07/15/2014
Personally Known V OR Produced Identification
Type of Identification Produced _AkAlrA,_ Maiii
STATE OF FLOl /Commission No.
Comm# FF912137
NOTARY PUBLIC
STATE OF FLORIDA
Comm# FF912137
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