HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
;- W' Date: ��A Permit Number: \ Nil 6553.
RECEIVED
Building Permit Application
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
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ST. Lucle County, permitting
Residential X
PERMIT APPLICATION FOR: Pool inground III
I PROPOSED IMPROVEMENT LOCATION: I
Address: 123 QUEEN FREDERIKA COURT
Legal Description: QUEENS COVE- UNIT 1 - BLK 4 LOT H (OR 4237-2758)
Property Tax ID #: 1414-701-0035-000-0
Site Plan Name:
Project Name: (-' OK POOL -
Setbacks Front Back: Right Side: Left Side:
Lot No. H
Block No. 4
DETAILED DESCRIPTION OF WORK: III
construction of in ground pool with spa, heater and paver patio.
I CONSTRUCTION INFORMATION: III
LJHVAC III Gas Tank UGas Piping
11 Electric 0 Plumbing ❑Sprinklers
Total Sq. Ft of Construction: _
Cost of Construction: $ 78,700
Shutters ❑ Windows/Doors
Generator 11 Roof
Sq. Ft. of First Floor:_
Utilities: 1:1Sewer O Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name TAMMIE R. COX
Name: JOHN M. MAY
Address: 123 QUEEN FREDERIKA COURT
Company: JM CUSTOM POOLS INC
City: FORT PIERCE State: FL
Zip Code: 34949 Fax:
Phone No.
Address: 2503 DYER ROAD
City: PORT ST. LUCIE State: FL
Zip Code: 34952 Fax: N/A
Phone No. 772-240-3278
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: Jmpools@bellsouth.net
State or County License: CPC1458456
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: III
DESIGNER/ENGINEER: _Not Applicable
Name: M. RANDALL RODGERS, P.E.
Addre55: ta01 HAZELWOOD DRIVE
City: FORT PIERCE State: FL
Zip: 3 V 48-t Phone: 772-201-1634
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State: _
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable I BONDING COMPANY:
Name: _
Address:
City:
Zip:
Name: _
Address:
City:_
Zip:
I certify that no work or installation has commenced prior to the issuance of a permit.
Phone:
_Not Applicable
St. Lucie Counttyy makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or anscovenants 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.
Si nature of 9van A en ee SigrAture of Contractor/Lkgnse LUMer
STATE OF FLORIDA STATE OF FLORIDA
COUNTYOF S7-• 4 ctcir COUNTYOF SST- LUC/J
The for�9ing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this S day of 5.110 I�EMBr'4 , 20 K by this _I!r day of5;XPT0m.&P , 20_W by
,o#Al m - m aV -Io!/A.) M . fnLy
(Name of person acknowledging I (Name of person acknowledging'}
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(Signature of Notary Public- St6t6 df Florida) (Signature of Notary Public- State of rida )
Personally Known I/ OR Produced Identification.
Type of Identification Produced
Commission No. ��
%iU., W LLII AM H
Revised 07/15/2014
Personally Known OR Produced Identification
Type of Identification Produced
No. &�e 73 1%�
WILLIAM H
EXPIRES April 12.
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