HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1'S 1�� Permit Number:
RECEI`70 FEB 13 2012
OWN
Building Permit Applicati®n
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: p dd
To Select from dro box, click arrow at the end of line
PROPOSED' 1M0R0VEM"ENT LOCATIQN.
Address: 8937 CHAMPIONS WAY
Legal Description: LAKES AT PGA VILLAGE(PB 43-32) BLK A LOT 22 (OR 3931-1823)
Property Tax ID#: 3334=501-0036-000-4 Lot No.22
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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DETAILED DESCRIPTION OF 1NC►RK kas
Q�d OD
Heater
Remove Existing'Gas Heater and replace with new as
Pentair P/N 460737 400k BTU NA Lo Nox 84% Efficient
Morningside Pools LP Gas License Specialty Installer C Certification No. 29627 License No. 32783
CONSTRUCTION°INFORMATION.
Additional work toa nertormed under this permit—cher all appy:
❑HVAC Gas Tank Gas Pi _ Windows
/Doors
Piping Shutters Doors11 ❑ /
Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 2350.00 Utilities:Sewer F—]Septic Build'ing•Height:
01tVNER/LES5'EE COIVTRAGTOR
,
Name RALPH H.&BARBARA E.LAFFLER Name: FRANK A. DETURA
Address:8937 CHAMPIONS WAY Company: MORNINGSIDE POOLS, INC.
City: PORT ST LUCIE State:FL Address: 1768 SE PORT ST LUCIE BLVD
Zip Code: 34986 Fax: City: PORT ST LUCIE State:FL
Phone No.561-632-1014 Zip Code: 34952 Fax: 772-337-2737
E-Mail:BOBBYJORAY@HOTMAIL.COM Phone No. 772-337-7151
Fill in fee simple Title Holder on next page(if different E-Mail: MORN INGS IDEPOOLS@BELLSOUTH.NET
from the Owner listed above) State or County License: CPC1456784
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRlJCT10N LIEN LA1N,lNFORMATIQN"
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 thepermit 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.
s.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF 19+ Lx._,r� e,
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of , 20 _by this—L day of F6'U_Ckv—i: ,20 LZ by
1
(Name of person acknowledging) (Name of person acknowledging)
a��".�•'6°�% BRENDA ANN LIS
MY COMMISSION t FF 01 9
l C EXPI 25, 8
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Flo Xo*`O Wed Thru Budget Notary Seis
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. (Seal) Commission No. (Seal)
Revised 07/15/2014 VA
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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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.
W-
s
Signa ure of Owner Less a Contractor as Agent for Owner Sign-Fe of Contractor/License Holder
STATE of I"LCIRIpi4� Lc�. FLORIDASTATE OF
CIF-
cauNrr � � � COUNTYOF
The forgoing instrument was acknowledged efore me The forgoing instrument was acknowledged before me
this 1-5 day of t�'-4 20 ( by this 1_15 day of F< 20 17 by
.l
{Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida),. ignature of Notary Public-State'of Florida)
Personally Known OR Produced Identification• Personally Known�''� OR Produced Identification
Type of Identification Produced Type of Identification Produced
(�/� -�7 -�9[J ,max w ORENG,A ANN LI13.3ER
F(-6 [ 6 / 7 / 1!' �+, Bl yl!uA�NNLI� r�b/d I r 9 P� *2h�,.
Commission No. * • )hhKt ) (I$SI�IVfF1=07commission No.. * * .SION
IFF07077
D(FI0E61nuaiy,2fi.2 18 uary 25,.201
Reviised 07/1512014 t
4:•
REVIEWS FRONT ZONING .:.,; SUPERVISOR PLANS VEGETATION SEA TU MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE `
COMPLETE
INITIALS