HomeMy WebLinkAboutBuilding Permit ApplicationALL A"PLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
® Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Lrrginio Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Pool inground
Address:
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Property Tax II
Site Plan Nam[
Project Name:
Lot No.J4 E3
m....r- •a.. 3
Setbacks Front 01 5 Back: /s Right Side: '/, S Left Side: 7, S
Installation of Gunite Pool, Deck and Equipment
HVAC Gas Tank ❑Gas Piping
ZElectric ❑✓ Plumbing 05prinklers
-JCO-'. aW
Total Sq. Ft of Construction: PM . -XAsntcv-
Cost of Construction: $ ✓.�
Shutters a Windows/Doors
Generator Roof
111LiOSFt. of First Floor: _
Utilities: Sewer o Septic
Building Height:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
Name Vl7
Name: Terry Wx
Address: \ vm
Company: Pools by Greg, Inc.
City: �- 1{JI State:fL
Zip Code:3� (Q�ird Fax:
Phone No. SNS- (oL.t( • (On L)
Address: 8886 S Federal Hwy
City: Port St Lucie
Zip Code: 34952 Fax: 772-337-9287
Phone No. 772-337-9713
State: FL
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: _
Name: M. RANDALL ROOERS
Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address: 1801 HAZELWOOODRIVE
Address:
City: FORT PIERCE
Zip: 84982 Phonem-m'-tam
State: FL
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER: _
Name:
Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
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
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, 1 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 youintend to obtain financing, consult with lender or an attorney before
commencing work or recording your Notice of Commencement.
Signature
as Agent for Owner I Signature of
110 -Ir M_
STATE OF FLORI A STATE OF FLORID Dy
COUNTY OF �� COUNTY OF
The forgoing instrument was acknowledged before me
this `� day of iib 20�aD by
TERRY WIx
Name of person making statement.
Personally Known is OR Produced Identification
Type of Identification
The forgoing instryfnent was acknowledged before me
this %ji- day of k06 20_-b by
TERRYWIx
Name of person making statement.
Personally Known G OR Produced Identification
Type of Identification
Produced
(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
VH I It�+r�I Notary Public Site W Fl
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AThoasina COMPLETED r
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,,, �r E><pires 03292022
Public State Of
03/292022