HomeMy WebLinkAboutHEATER PERMIT PACKALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2900 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR:
Address: 11) l0 i-
Legal Description:
Property Tax ID #::
Site Plan Name:1
Project Name:
Setbacks Front
Back: Right Side: RY Left Side: to (o
�0f �001 94JIrn%t iF9bb
EIHVAC LJ Gas Tank ❑Ga!
Electric ❑✓_Plumbing nSpi
Total Sq. Ft of Construction:
Cost of Construction: $ 5 Ll i. 1 i `J
—cneCK a
Piping "Shutters
>rs " Generator
S Ft. of First Floor: _
Utilities- Sewer [J Septic
Lot No. 1 a
Block No.
Windows/Doors
0 Roof
Building Height:
�a.. ixi ..
N.
lfi
Name
Name: Teny Wix
Address:
Company: Pools by Greg, Inc.
City: �kf r State
Zip Code: ✓ (46 Fax:
Phone No.11a'bi0q a5i9
Address: 8886 S Federal Hwy
City: Port St Lucie State: FL
Zip Code:34952 Fax:772-337-9287
Phone No. 772-337-9713
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: office@poolsbygreginc.com
State or County License: CPC1458338
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:M. IWIO LLROGERS
Name:
Address: 'so' HAZELWOOD DRIVE
Address:
City: FORT PIERCE State: FL
City: State:
Zip:34982 Phonem-201-t&34
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
BONDING COMPANY: _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 the permit holder to build the subject structure
is in Home Owners Association bylaws that may restrict or such
which conflict with any applicable rules, or and covenants prohibit
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
cornmencing work or recording our Notice of Commencement.
Signature of 0 / Lessee/C ntractor as Agent for Owner
Signature of on actor/Licen Holder
STATE OF FLOR�Q 1',
STATE OF FLORIDA
,)'C
COUNTY OF f twit
COUNTY OF
The for oing instrument was acknowledged before me
this day of RA 20a by
The forgoing instrument was acknowledged before me
this —5- day of RY 202Dby
TERRY WIX
TERRY WIX
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known Y OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
�f
y�
(Signature of Notary Public- State of Florida )
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. PLI S ale Of On 3a No ary Public State or Fiords
No, A Thomasina Bowlns
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My COO Via` My Commium GG 201733
' 2022 �Y' EzOires 03/29/2022
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