HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: \TUA Permit Number:
Building Permit Applicatio RECEIVED
Planning and Development Services
Building and Code Regulation Division NOV 2 9 201a
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial f�t4aV�ri, Pern
PERMIT APPLICATION FOR: Electrical _
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PROPOSED] MPROVEM ENT LOCATION: ppv n
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Legal Description: HOLIDAY PINES S/D-PHASE II -A- LOT 177 (MAP 13/12S) (OR 3935-1708)
Property Tax ID #: 1312-800-0008-000-3 Lot No.
Site Plan Name: Block No.
Project Name: Christianson
Setbacks Front Back: Right Side: Left Side:
DETAILED -DESCRIPTION OF WORK: '
INSTALL ROOF MOUNTED SOLAR PV SYSTEM. 9.145KW
CONSTRUCTION INFORMATION:
itiona wor to Die pertormed un er t is penult— check all apply:
1JHVA1 Gas Tank ❑Gas Piping _ Shutters Windows/Doors
ZElectric Plumbing ❑Sprinklers Generator E]Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 18290 Utilities: LLl Sewer Eheptic Building Height:
OWNER%LESSEE:;
CONTRACTOR,
Name Christianson, James R
Name: DANIEL YATES
Address:5202 Indian Bend LN
Company: GULF ELECTRICAL SERVICE
City: Fort Pierce State: FL
Zip Code: 34951 Fax: N/A
Phone No. M: (206) 914-1481
Address: 4897 W. WATERS AVE
City: TAMPA State: FL
Zip Code: 33634 Fax: N/A
Phone No. 727.218.9407
E-Mail: N/A
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: BAPROJECTSOLUTIONS@GMAIL.COM
State or County License: EC13001255
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
�SUPPLEMENTAL•CONSTRUCTION'LIEN LAW INFORMATION.,
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone 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: 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 contlict 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 approvedplans, 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 vour Notice of Commencement.
Signature of Ow r/ Lessee7Contractor as Agent for Owner
Signature of Contractor icense Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF sT LUCIE
COUNTY OF ST LUCIE
The ing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this!or$oday of IV av 2018 by
this=day of A10%1
2018 by
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Name of person making statement
Name of dson making
statement
Personally Known OR Produced Identification x
Personally Known
OR Produced Identification x
Type of Identification
Type of Identification
Produced DL
Produced oL
a�
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(Signature of Nota Public-
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Stets of FloridaCommission
• My Commission GG 245871
Expires 08/15(2022
ion GG 248571qp
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Rev.8/2/17