HomeMy WebLinkAboutBuilding Permit Application ' is
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED f�
Date: `T'�—� Permit Number:
RECEIVED
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Building Permit Application APR 0 8 2019
Planning and Development Services ST. Lucie County, Permitting
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 EL �Y
PROPOSED IMPROVEMENT LOCATION:
Address: 11675 TWIN CREEKS DRIVE
Legal Description: TWIN CREEKS I -LOT 15 AS RECORDED IN PLAT BOOK 23, PAGES 42 AND 42A
Property Tax ID#: 2333-601-0015-020-8 Lot No. 15
Site Plan Name: ORTIZ Block No.
Project Name: POOL HEATER
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
INSTALL A HEAT PUMP TO EXISTING POOL.
CONSTRUCTION INFORMATION:
Additional work toe performed under tispermit—checka appy:
HVAC E]Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers I Generator E] Roof
Total Sq.Ft of Construction.- _ _ Sq. Ft.of First Floor:
Cost of Construction:$ f 2!VOQ Utilities:0Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name JAVIAR ORTIZ Name: JOHN M. MAY
Address: 11675 TWIN CREEKS DRIVE Company: JM CUSTOM POOLS INC.
City: FORT PIERCE State:FL Address: 2503 DYER ROAD
Zip Code: 34945 Fax: City: PORT ST. LUCIE State:FL
Phone No. Zip Code: 34952 Fax: N/A
E-Mail: Phone No. 772-240-3268
Fill in fee simple Title Holder on next page(if different E-Mail:Jmpools@bellsouth.net
from the Owner listed above) State or County License: CPC1458456
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: 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
commencijlg work or recording your Notice of Commencement.
Signif re of Owner/At gen ee Signa re of Contractor icense Holder
STATE OF FLORIDA STATE OF FLORID
COUNTY OF Sr-• Lf c>F COUNTY OF
The forgoing instrument was acknowledged before me The for of g instrument was acknowledged before me
this�day of A-P 9 j L 20�by this oday of &P A-1 L— 20_1 by
/0'Z1 I-/-rJ�-� /'Zz" 114
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary,Public-State of Florida)
Personally Known l�011 Produced Identification Personally Known ✓�OR Produced Identification
Type of Identificatio Type of Identification Produced
WILLIAM H DONOVAN JK
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Commission No. My COMMIpagq#GG093576 Commission No. ;�;!aY"%•' W lhIyl H DONOVAN JR
EXPIRES April 12,2021 MY COMMISSION#GG09357
�� •.. EXPIRES April 12.2021
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
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