HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / r,
Date: ' �� Permit Number: / d L"
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Building Permit Application
Planning and Development Services JAN 10 2010
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: To Select from dropbox, click arrow at the end of line
PROPOSED IMPRQI/EMENT LO`CATIQN
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Address: A,- Rzo 2 �l A l�(��1-� l��_ F—s C— _: /Y RA
Legal Description: POD 25 AT THE RESERVE LOT 8(OR 3505-1401:4079-789)
Property Tax ID#: 3327-705-0009-000-0 Lot No.8
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
7777777 ,
DETAILED DESCRIPTION QF WORK T ,
REMOVE EXISTING 400K LP HEATER & REPLACE WITH NEW GAS HEATER
PENTAIR P/N 460737 400K LP GAS HEATER
MORNINGSIDE POOLS LP GAS LICENSE SPECIALTY INSTALLER C CERT#29627 LIC # 32783
CONSTRUCTIONiR
INFORM; TION
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Acid itional work to b.enertormed under this permit—check all tha appy: .
HVAC Gas Tank Gas Piping Shutters Windows/Doors
Electric Plumbing Sprinklers -0 Generator E] Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 20eL9 Utilities:Sewer❑Septic Building Height:
01'lI,I�NER/LES5�E '
1,Na'i .AZI47L AG /lz'_ Name:
Address:;, R10.5./ ct'/kY/ _ Company: MORNINGSIDE POOLS, INC
City: State: Address:
Zip Code: _!gWe& Fax: City: PORT ST LUCIE State:FL
Phone No. FzSr 38tp— Zip Code: 34952 Fax: 772-337-2737
E-Mail: Tr1� C/C Sc--p!!/L �_s GGC- Phone No. 772-337-7151
Fill in fee simple Title Holder on next page(if different E-Mail: MORNINGSIDEPOOLS@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.
SUPPLEMENTAL CONSTRUCTION.LIEN LAW INFORMATION:
/ ApplicableMORTGAGE COMPANY: Not
DESIGNER ENGINEER: x Not x Applicable
Name: Name:
Address: Address:
City: State: City: PORTSTLUCIE 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 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.
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Signature of Owner/Lessee/Contracto ent fo Tis Signature of Contractor/ icense .
STATE OF FLORIDA ="2 STATE OF FLORI
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COUNTY OF m�� COUNTY OFCD
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The forgoing ins Tent was acknowledged before 8 o�~ The forgoing instrument was acknowledged before me
this day o 20� by ¢�W this day of.CMX_U._T�1 2019 by
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Name of person making statement `o_ Name of pe n making statement
Personally Known OR Produced Identificat i;: :� Personally Known ✓ OR Produced Identification
Type of IdentificaType of Identification
'
Produced C Produced
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(Signature of votary Public-State of Florida ) (Signature of Notary Public-StateofFlorida)
Commission No. (Seal) Commission No�� U`7y�1"1 a°s; BRENDA ANN L R
*
*'-My COMMISSION i F 779
Nr °F EXPIRES:January)5, a
OF F� ICES
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17