HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONCOMPUTED FOR APPLICATION TO BE ACCEPTED I �
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Building Permit Application �
Planning and Development Services
Building and Code Regulation Division
2300 Vi�ginia Avenue, Fort Pierce FL 34982
Phone(772) 462-1553 Fax: (7.72) 462-1578
Commercial R1
SEP 2 7 2018
Permitting Department
St. Lucie County, FL
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PERMI ! T APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION: 'SO I
Address- Dy�\� Fazl:
Legal Description: INDIAN RIVER ESTATES UNIT 08 BLK 55 LOT 28
Property Tax ID#: 3402-609-0126-000-1
Site Plan I Name: JOHNSON PV
Project Name: JOHNSON PV
Setbacks Front— Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
INSTAL A 2.5 KW SOLAR PHOTOVOLTAIC SYSTEM (ROOF MOUNT).
Lot No. 28
Block No. 55.
CONSTRUCTION INFORMATION:
Additional work to a erformed under this permit— check all apply: ❑E] 0❑Win dows/Do.ors
H,AC Gas Tank Gas Piping Shutters
ZElectric ❑ Plumbing E]Sprinklers ElGenerator ❑'oof- Roof pitch
Total Sq. Ft of Construction: S Ft of First Floor:
Cost of Construction:$ 12,000 Utilities: Sewer 0Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name mvrct Djprns
n
Name: kbb_1Q,
I
Address: 5,501 ittm
Company: AMERICAN P6,AIER SOLUTIONS
City:. Sou I e-Tcc State: FL
Zip Code: 34982 Fax:
Phone No. 772-468-8863
Address: WN(v 0\,,
City: LC&,. HUrul State: FL
Zip Code: 32746 Fax:
Phone No. 786-656-1199
E-Mail:i
Fill in fee simple Title Holder on next page if different
from the Owner listed above)
E -Mail: PERM[TAMPS@GMAIL.COM
State or County License: EC13008 574
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
I
SU,PPL'EMENTAL CONSTRUCTItON" Lf hl LAW, INFORMATION:
DESIGNS /ENGINE R: _ Not Applicable
`kc �e
MORTGAGE COMPANY: _ Not Applicable
Name:I 11
Name:
Address: 301 III
Address:
City: Sta e• L
City: State:
Zip: ' Phone 46► — 4-7)4 I I
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address: 1657 WEST PARKWAY
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 inlcontlict 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, 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
commenciwork ourecordine vour Notice of Commencement_
Signature of OVA&I Lessee/Contractor as Agent for Owner
Signature of Cont ctor/ ense Holder
STATE OF FLORID
STATE OF FLORMS
COUNTY OF R6
COUNTY OF
The f oing inst ment wa ac nowledged before me
thist�day of 20 by
The forgoing instr ent acknowledged before me
this q day of 2011 by
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Name of person making statement
Name of p n ake statement
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Personalty Known OR Produced Identification
Personally Known OR Produced Identification
Type of Ide ficatio
1&L
Type of Identification
Produced
Produced
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of Notary Pu/b Iic- Iyate * i ) Comrttissfm#GAdI
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Signature of Notary Public- Sta ida)
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SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
tev. 8/2/17