HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1
Date: MARCH , 2019 RECEIVED Permit Number: 1os—�s
WQ-MAR 2 5 2019
_•_____ — ST. Lucie.0 nt P 'mittin -
I Mit Application
Planning and Development Services
Building and Code Regulation Division r 1
2300 Virginia Avenue, Fort Pierce FL 34982 W—
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT TYPE: Solar
Address: 12741 REFUGE LN, JENSEN BEACH, FL 34957
Property Tax ID #: 4504-702-0004-000-2 Lot No. 3
Site Plan Name: EDEN'S REFUGE Block No.
Project Name: JAMES P COLLINS PV SYSTEM
INSTALLATION OF GRID -TIED PV
Additional work to be performed under this permit —check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
X Electric _Plumbing _Sprinklers _Generator _Roof
Total Sq. Ft of Construction:
Cost of Construction: $ 30,346.28
Name JAMES P COLLINS
Address: 12741 REFUGE LN
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
City: JENSEN BEACH State: FL
Zip Code: 34957 Fax:
Phone No. (863)430-9553
E-Mall: JIMMYPCOLLINSCdGMAIL.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
LYNN BURDICK
Pitch
Company: WINDMAR HOME FLORIDA, INC.
Address: 7575 KINGSPOINTE PARKWAY, SUITE II
City: ORLANDO State: FL
Zip Code: 32819 Fax: _(407) 502-7055
Phone No (407)308-0099
E-Mail NEAL.BURDICK@WINDMARHOME.COM
State or County License EC0002179
Fvalue of construction Is $2500 or more, a RECORDED Notice of Commencement is
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name; MIGUEL A ALVAREZ VELEZ
Name:
_
Address: 7675 KINGSPOINTE PARKWAY, SUITE II
Address:
City: ORLANDO State: FL
City:
State:
Zip: 32819 Phone (4o7).306-0099
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY:
Applicable
Name:
Name:
_Not
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 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 �T,,H�E�JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITU-MIUR �lIYUXR OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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Si nature of c n r/ Less Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FL RDA
STATE OF FLORIDA
COUNTY OF INT LUCIE
COUNTY OF SAINT LUCIE
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 20THday of MARCH , 2019 by
this 20THday of MARCH . 20yA_ by
CHAD ROGERS as POA for JAMES P COLLINS
_...._ .._HEAL LYNNf3UR01.CK__ .
Name of person making statement.
Name of person making statement.
Personally Known X OR Produced Identification
Personally Known X OR Produced Identification
Type of Identification
Type of Identification
Produced
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