HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONNotarize ID: GX693G9C
ALL APPLICAB E INFO MUST BE COMPLETED FOR APPUGATION 0 BE ACCEPTED
Dater % / Permit Number:
. SCANNED
Build nPLTi�r�nit Wpplication
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 Res
PERMIT APPLICATIONFOR: Electrical
P • ®I'®�� �®i PRO � , C1C✓ I'®�N • _
Address: 2110 Oak Dr, Fort Pierce, FL 34949
RECEIVEC
APR 19 2018
Permitting Departmen
St. Lucie County, FL
en
Legal Description REV PL OF FORT PIERCE SHORES -UNIT 5-BLK 43 S 1/2 OF LOT 3 AND ALL LOT 4
(OR 534-2626)
Property Tax ID #: 1436=602=0040-000/2 Lot No. 1, 2
Site Plan Name: Solar Project
Project Name: Barnes Solar Project
Setbacks Front Back: Right Side: Left Side:
Installation of Solar Rooftop PV System - 6.09kft 21 Modules
LJHVAC. t _l Gas Tank L _JGasPiping, �15hutter5
2Electric 0 Plumbing: 'Sprinklers a Generator
Total Sq, Ft of Cdnstructlon S . Ft. of First Floor: _
Cost of Construction: 13,032:6q Utilities. ❑Septic
Name Clifford Bamos
Address,: 2110 Oak D..rive
City: Fort Pierce State: FL
Zip Code,• 34949
Fax:
Phone No. (772) 519-1814
F-Mall: cliffnow@hotmail.corn
Fill :in fee simple Title Holder on next page :( if different
from the Owner listed above.)
If value of constructlon'is $2500 or more; a:11EC0110ED Notice of
Name: Brandon Siegel
Block No. 5
.[] Windows/Doors
E]Ro.of Roof pitch
Building Height:
Company: ESA "Solar Energy, LLC.
Address: 801 International Parkway, Ste. 500
City: Lake Mary State_: _ FL
Zip Code: 32746 Fax:
Phone No. (407) 461-7556
E-Mail: bsiegel@e..sa-solar.com
State or County License: EC13008032
is required.
Notarize ID: GX693G9C
1:51, 11315 _40Q1116
F
50_M
oil RM
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: X Not Applicable
Name: David K. Click
'Name:
Address:
Address.- 8611nternationalParkway.Ste. No
City: Lake Mary State: 'FL
City: State:
Zip: '32746 Phone (401)461-75519
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
BONDING COMPANY: x Not Applicable
Name:
Name:
Address!
Address:
City:
City:
Zip: — Phone:
Zip: :Phone--
OWNER/ CONTRACTOR AFFIDVIT: Applications hereby made to -obtain a permit to do the work and installation as indicated.
.1 certify that no work.or installation has commenced prior to the issuance of a permit.
St. Lucie makes no.represerttaiion that is granting -a permit will authorize the permit holder to build1he.subject structure
7
which Is In conI,ct With any -applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure.Please consult with,your Horne Owners As's ciatl6n 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 a pproved plans, the, Florida .13ulldirigCodes and St. Lucie. County Amendments.
The following building permit applications are exempt from .undergoing a full concurrency review: room additions,
,accessory 9tructi4resswimming pools, fences., walls, signs, screen rooms and accessory uses to another non-residential use
WARNINGTO OWNER., Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property, A Notic.6,of,Corhrhencement,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
commencinia work or recording vour Notice of Commencement.
C4f get-,roxs Z�_�ea
Signature .of Owner/ Lessee/Contractor as Agent for Owner righatureof Contractor/License Holder
STATIE"OF V1,RGUNIA STATE OF FLORIDA
COUNTY OF —Campbell COUNTY OF -, Sf*6i mo te—,
The fotgoirigin'strurnent Was qcknOwledged.be re Me The-lorgoin'ginstrument was 'acknowledged before me
.
this 17 day of 20 this
'A _17. by _1rdayot...,*y-(l' 20_1t by
Clifford Barnes IOWA Y--
Name-of person making..statement NaMe-of peeson making statement
Pe OR Pfoddt d identification
Persom Ily Known! - OR Produced Identification . ✓ ts. . ona lly Known 3<
Type of Identification Type of Identification
Produced briverls license Produced IF 5 F 5 A N S EV EN S
LTN 0, T
Commission G 6.0660
vp� A My Commission Expires
January 09, 2021
'(Signature of Notary PUa+ State of vx= - =1:!!: N M gnature of Notary Public -State of Florida
a.."
s! Claz
Cqe in ..01V
m4p 'on No. ga-W BR ommission, NO. G ifi �'Dloa (Seal)
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I - (41 al;V . F
COhIM. EX`0.: 01/31/2020
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Rev. 8/2/17