HomeMy WebLinkAboutBuilding permit appALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial Residential X
PERMITAPPLICATION FOR:
Address:
Legal Description:
Property Tax ID #: 0
Site Plan Name: M
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Lot No.—
Block No.
LDETAILED DESCRIPTION OF WORK:
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�PIo�C�r� SK�mmey, ff�rl�v,�-�1�oY 5�j�i�,r►'1
F-1 MIL —cnecK auapply
HVAC Gas Tank ❑Gas Piping Shutters
a Q Windows/Doors
®Electric Z.Plumbing,ot 5
' D
lrinklers Generator
0 2CIL Roof
Total Sq. Ft of Constructional S Ft. of First Floor:
Cost of Construction: $ � ,M(� Utilities:llSewer ❑Septic Building Height:
Address: 's SI��Trnnnit�li�1 �Rr
City: S L, Stater
Zip Code: Fax:
Phone No.(Ql•
E -Mail:
FII in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: Terry Wix
Company: Pools by Greg, Inc.
Address: 8886 S Federal Hwy
Ci Port St Lucie
�' State: FL
Zip Code: 34952Fax: 772-337-9287
Phone No. 772-337-9713
E -Mail: office@poolsbygreginc.com
State or County License: CPC1458338
value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION
__.-1 _ Not
M- RANDgLL ROGERS
LIEN LAW INFORMATION:
Address: +a01 NA2FyWOOD DRIVE
City; FORT %E RCE
Zip; „see PhoneState: FL
� me -2o+-,63.
FEESIMPLE TITLE HOLDER:
Name: —Not Applicable
Address:
City-
ZIP: .� Phone:
MORTGAGE COMPANY:
Name: _ Not Applicable
Address:
City.-
Zip.
ity:Zip: State:
� Phone:
BONDING COMPANY:
Address:
_Not Applicable
�rnune:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to da the work and installation as indicated.
I certify that nttyo work or installation has commenced prior to the issuance of a permitp.
which is In conflicmt with any epplicableiHo eaOwners gssoc+atlonirules abylaws or and coevianser td thesubject
iectsruisuntbuild
aostructure
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 1 will, in all respects, in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
P Perform the work
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
commencin work or recordin our Notice of Commencement.
Signature o, WRer/ Lesseentrador as Agent for Owner
�/ JCoSignature ofCrra=r/License Holder
STATE OF FLORIDA
COUNTY OF �AaCI�
Thergoing instrument was acknowledged before me
this day of . �► ]f(� 20-Wby
TERRY WIX
Name of person making statement.
Personally Known_)<_OR Produced Identification
Type of Identification
STATE OF FLORID
COUNTY OF 4 VUJk
The f oing instru ent was acknowledged before me
this � day of � J 20X by
TERRYwx
Name of person making statement.
Personally Known 7I OR Produced Identification
Type of Identification
Produced
(Signature ofNrylic- State of Florida) (Signature of Notary Public- State of of Florida )
Commission No. (Seal)
REVIEWS FRONT ZONINGSUPERVISOR
COUNTER REVIEW REVIEW
A Thomasina Sowins
My commission GG 201733
Expires 03292022
Commission No. (Seal)
PLANS [VEGUT'TION SEA TURTLE MANGROVEREVIEW EW REVIEW REVIEW
Notary vuoxo aww v" �.....
A Thomasina Bowins
p p My Gommnsion GG 201733
p �{' Expires032912022
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