HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONNotarize ID: DJ7X7FHP
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I ll
Date: Permit Number: �bi—� V `I, 6 c.
��l�NNED,
RECEIVED
BuilAvOermit$1Application APR 13 2018
Planning and Development Services Permitting Department
Building and Code Regulation Division St, Lucie County
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVE MENT`LOCATION:
Address: 1300 W 1st St, Fort Pierce, FL, 34982
Legal Description: WHITE CITY BILK 73 LOTS 19, 20, 21 AND 22 AND W 1/2 OF VAC ALLEY ADJ ON E OF LOT 19
AND S 1/2 OF VAC ALLEY ADJ ON N OF LOTS 19 AND 20,21, AND 22
Property Tax ID #: 3404-501-0434-000-8 Lot No.19,20,21,22
Site Plan Name: Solar Project Block No. 73
Project Name: Barnes Solar Project
Setbacks Front Back: Right Side: Left Side:
'DETAILED DESCRIPTION OF WORK:
Installation of Solar Rooftop PV System - 4.93kW
`CONSTRUCTION INFORMATION:
Itlond wor to je ne orme under tis permit— c ec a apply*
�HVAC L_J Gas Tank Gas Piping _ Shutters a Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft.. of First Floor:
Cost of Construction: $ 10,353.00 Utilities: ;Sewer Septic Building Height:
OW N E RAESS.EE:
CONTRACTOR:
Name SRFMO LLC
Name. 400wodI1111111W
Address: 1300 W 1st ST
Company: ESA Solar Energy, LLC.
City: Fort Pierce State: FL
Address: 801 International Parkway, Ste. 500
Zip Code: 34982 Fax:
City: Lake Mary State: FL
Phone No. (772) 519-1814
Zip Code: 32746 Fax:
E-Mail: cliffnow@hotmail.com
Phone No. (407) 461-7556
Fill in fee simple Title Holder on next page ( if different
E-Mail: bsiegel@esa-solar.com
from the Owner listed above)
State or County License: EC13008032
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
r- Notarize ID: DJ7X7FHP
�SUPPLEME(�TAL CONS'TRUCI'10N LIEN IAW �N:FORI�lATION �{ � ��' � �v�" "°� {
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DESIGNER/ENGINEER: _Not Applicable
MORTGAGE -COMPANY: X Not Applicable
Name: David K. Click
Name:
Address: _ _
Address: 801 IntemaSonal Parkway, Ste. soo
City: Lake Mary State: FL
City: State:
Zip: 32746 Phone (407)461a556
Zip: Phone:
FEE SIMPLE TITLEHOLDER: - - x - Not Applicable
BONDING COMPANY: X 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 reviewyour 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 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 your Notice of Commencement.
c4fo--ew a
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF VIRGINIA
COUNTY OF ARLINGTON
The forgoing instrument was acknowledged before me
this2nddayof March ,20_M by
Clifford Barnes
Name of person making statement
Personally Known OR Produced Identification ✓
Type of Identification - - ._ _- - .10.1;,,,,; -
Produced FL drivers license \�\\\�`g/ LT H„O
\20 �OVNCAN.� s
T y1: aOTAR12F .y
(Signature of Notary Public- State of
I ayshawn Duncan -Whitcomb %40 ate{
Commission No. 7551205
Signature of Contractor/License'HoIder
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this day of . 20_ by
Name of person making statement -
Persona lly.Known OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
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