HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
SCANNED
RECENED
c g BY SEP 0 5 2019
•moo dingPA1671 1i Permitting
BU91
Application Department
Planning and Development Services
St. Lucie County
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
Residential xxxxx)O=
PERMIT APPLICATION FOR: Building
PROPOSED IMPROVEMENT LOCATION:
Address: 434 SE Tranquilla Ave Port Saint Lucie, FL 34983
Legal Description: RIVER PARK -UNIT 4 BLK 34 BEG ON SLY LI LOT 364.50 FTELY OF MOST ELY CDR LOT 4, TH CONT ELY ON SLY U LOTS 2 AND 39822 Fr, THN 36 DEG 47
MIN 22 SEC W 140 FT, TH RUN SWLY ON NWLY LI LOTS 2AND 3103 FT, TH S 38 DEG 44 MIN
42SEC E 140 Fr TO POB BEING PART OF LOTS 2 AND 3 BEING TRACT H(MAP3W8N)
Property Tax ID #: 3419-530-0079-000-7
Lot No.
Site Plan Name: Jisel Leon
Block No.
Project Name: Jisel Leon
Setbacks Front Back: Right Side:
Left Side:
DETAILED DESCRIPTION OF WORK:
Solar PV System Roof Mount & Interconnection
CONSTRUCTION INFORMATION:
Itiona wor to e e orme under this permit- check
0HVAC Gas Tank ❑Gas Piping
all apply:
_ Shutters ❑ Windows/Doors
EElectric Plumbing Sprinklers
Generator El Roof Roof pitch
Total Sq. Ft of Construction:
So. Ft. of First Floor:
Cost of Construction: $ $34,731.85 Utilities:11 Sewer 0Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ,
Name: Rafael Angel Gonzalez Mendoza
Address:
a �12 •
Company: Go Solar Power LLC
City: StateOL—
Address: 801 SE 6th Ave
City: Delray Beach State: Fl
Zip Code: Fax:
Phone No:
Zip Code: 33483 Fax:
E-Mail:
Phone No. 561228-4483
Fill in fee simple Title Holder on next page ( if different
E-Mail: Jackson@gosolarpower.com
State or County License: CVC56962
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY:
Name: Rafael Angel Gonzalez Mendoza
_ Not Applicable
Address: 434 SE Tranquilla Ave Port Saint Lucie, FL 34983
Address:
City: State:
Zip: Phone
City: Delay Beam
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY:
Name:
_Not Applicable
Address:801 SEBthAve
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 the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commen-cing work or recording your Notice of Commencement.
ignature Contractor as Agent for Owner
Signature-OfContractor/License o -
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF st wde
COU NTY OF st wda.
The forgoing instrumen was afkn_owledged efore me
this day of . � M I^P /. 201by
The foilgoing inment was acknowledge fore me
this, day of n L� , 20 by
h
Name of per o making statement
Name of perso aking statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signs ure of No S
``SS
(Signature of Nota i
' bf fthwa3S
COMMISSI N # GG227387
Commission No-*_ eal
2022
�v
Commission No.: f ' MISSIONIg
•..•,.. IRES: J�un� 11,
' Bonded ihlu Aamll Notary
s EXPIRES: June 11,
2022
°�i o�Thru
n Notary
REVIEWS
FRONT
ZONING
UPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17