HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONsI
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Date:
CABLE INFO MUST BE COMPLETED FOR APPLICATION TO BEACCEPTi?D �/
Permit Number: /O� / .' ai"o2?
Building Permit Application
Planni and Development Services SEp 191018
Building" and Code Regulation Division ST
�IKYe
2300 ,� glnla Avenue, Fort Pierce FL 34982
Phon II (772) 462-1553 Fax: (772) 462-1578 Commercial Residential' �""
PERMIT
APPLICATION FOR; Other P(QANMED
PROP
b SED IMPROVEMENT LOCATION: BY
Addr(
Legal
15362 Navion Drive Port Saint Lucie, FL 34987
n: TREASURE COAST AIRPARK LOT 96 (4.96 AC) (OR 2065-928)
tji; ISl GIG k�-.Oumurty
Properti"Tax ID #: 4Lc4-5u-i-vuan-vuu-r Lot No. vb
Site Pla Name: Barry Peal Block No.
Project ' a me- Barry Peal
Setbac s Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Solar PU System Roof Mount
..CONSTRUCTION INFORMATION:
Add-itional work o {e performed
orme under is permit—checka a apply:
FIH ,AC 1_! Gas Tank ❑Gas Piping 0 Shutters ❑ Windows/Doors
❑El ctric Plumbingn❑GtRoof Roof pitch
eneraor ❑
- - []Sprinklers -� �
Total Sci,Ft of Construction: S . Ft. of First Floor: -
$70,400
Cost of onstruction: $ Utilities: Sewer ❑Septic Building Height:
1,
OWNEIR/LESSEE-
CONTRACTOR:
Name
Address'
City: - Tr�
Zip Cod
Phone N
E-Mail:
Fill in fe
from th
� (�CR,t'
Name: Rafael Angel Gonzalez Mendoza
Company: Go Solar Power LLC
IO'ol r'�1xtoe-) V2�<.
S'�- L,1UA _' State:
�: 1-9 Fax:
' ._601— ZZ �—LIYo `�5
Address: 801 SE 6th Ave, Suite 206
City: Delray Beach State: FL
Zip Code: 33483 Fax:
Phone No. 561-228-4483
ackson osolar r ram.00m
E-Mail: j @9 P o9
C •C
simple Title Ho der on next page (if different
Owner listed above)
State or County License- CVC56962
It value of�constructlon is �2500 or more, a RECORDED Notice of Commencementis required.
SUPPLEMENTAL
r
CONSTRUCTION LIEN LAW INFORMATION: P
DESIGNER/ENGINEER:
Nam
Addr �'sIs°
City:
zip:
— Not Applicable
` _
MORTGAGE COMPANY: — Not Applicable
Name: ftfaet AnreB Ganza!¢ ?�1eaCoza
Address:
City: Derray Beach State:
Zip: --__ Phone:_— — —
_
_
—tL�,3v:D�,�st�,de.FL3d43
. — --_State:
111 Phone_ —
'I °
FEE S
Nam
Address:
city:_[.
Zip:
MPLE TITLE HOLDER: — Not Applicable
BONDING COMPANY: —Not Applicable
Name:
801 SE 6MAve. Slele206 --
Address:
City:
—
1' _ Phone:— _
I.
Zip: Phone:
OWNE' 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
which Is
structur
In consic
in accon
The folic
a ccessor
WARN
improti
before
Comm I
ounty makes no representation that is granting a permit will authorize the permit holder to build the subject structure
conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
ration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
nce with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
,Ing building permit applications are exempt from undergoing a full concurrency review: room additions,
structures, swimming pools, fences, walls,signs,screen rooms and accessory uses toanother non-residential use
IG TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
ments to your property. A Notice of Commencement must be recorded and posted on the jobsite
he first inspection. If you intend to obtain financing, consult with lender or an attorney before
icing work orAecording your Notice of Commencement.
Wr
Signattl,re of Owner/ Le seas Agent For Owner
Signature of Contract r/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF St. Lucie
COUNTY OF St Lucie
_
The foi` go ng instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this C day of SL- 2 JUtYlhoa;. 20Z by
this _a day of 09 , 26A by
Bgfael AngQ1rmnZalez MendgiZa
-------
Name of persorlrKaking statement
Name of person ak'ing statement
70R
Personally
Known DR Produced identification
Personally Known Produced identification
Type of
identification
Type of identification
Produ
ed
Produced
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