HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED n
Date: -I • 14 Permit Number:
E C VR0
Building Permit Application SEP 1 <' 2010
Planning and Development Services PER.'01TTING
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential .x
PERMIT APPLICATION FOR: Mechanicals ` C
PROPOSED IMPROVEMENT LOCATION:
Address: 4881 Jorgensen Road Ft. Pierce, FL 34981
Legal Description: WHITE CITY S/D 05 36 40 S 202.97 FT OF LOT 84 (MAP 34/0-05N)
(3.07 AC) (OR 1117-2073)
Property Tax ID#: 3403-502-0147-010-2 Lot No.84
Site Plan Name: NADEAU Block No.
Project Name: NADEAU
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
G Solar e C cin cLn M-9byLg
CONSTRUCTION'=INFORMATION:
Additional work to be rformed under t ispermit—check all h appy:
HVAC Gas Tank 0Gas Piping In Shutters []Windows/Doors
11 Electric 0 Plumbing 11 Sprinklers Generator 11 Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction: $ 800.00 Utilities: Sewer E]Septic Building Height:
OWNERAESSEE CONTRACTOR:
Name Raymond Nadeau Name: James E. Ogle
Address:4881 Jorgensen Road Company: Simply Solar Services, Inc.
City: Ft Pierce State:FL Address: 866 Duncan Ave.
Zip Code: 34981 Fax: City: Kissimmee State:FL
Phone No.772-646-7777 Zip Code: 34744 Fax: 407-847-5013
E-Mail: Phone No. 407-846-7830
Fill in fee simple Title Holder on next page(if different E-Mail: info@simplysolarservices.com
from the Owner listed above) State or County License: CWC035772
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:
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
commencing work or recording our Notice of Commencement.
L IA ,,,� ,z �� I
s
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Co tractor/License Ho r
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STLUCIE COUNTY OF STLUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this ` day of sfDPi� 20 I(vby this day of �ep}�n1�-p.,� ,20 4-by
Raymond Nadeau 1 James E.Ogle
(Name of person acknowledging) (Name of person acknowledging)
(Signature of otary ublic-State of Flori (Signature of,14otary Public-State of Flor' )
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced ppp��Y���/N�� p Type of Identification Produced �/� p� /�
•gPPY PLB•, 9V1 \" COSTA.O\9ZO ,40.aY PUe, Mt= COSTi4 y
Commission No. =2:" Commission No. ts; a, ,�_;_
MY COMMISSION#FF175797 \ ;Q MY COMMISSION#FF1 `z:
EXPIRES December 5. n
'•'.e''"OP• EXPIRES December 5 2018
(407)398-0153 FloridallotaryService.conn (407)398-0153 Florida NotaryService.ct
Revised 07/15/201
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