HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3 9-92o Permit Number: t ob- 0i/ 1q
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Building Permit Applicatio JUN 2. 3 2020
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
Perinit:t'n !-,u;pe.rtrnent
Resiaent,aI,kX COUnty E I -
PERMIT APPLICATION FOR: Pool inground III
PROPOSED IMPROVEMENT LOCATION:
Address: 5180 NW DUNN ROAD
Legal Description: DUNN ROAD ESTATES S/D (PB 46-1) LOT 4 (2.35 AC) (OR 3930-2113)
Property Tax ID #: 3403-702-0005-000-6
Site Plan Name: DUNN RD
Project Name: REALS
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION OF IN GROUND POOL 8 CONCRETE PATIO
Lot No. 4
Block No.
d-v l C'Ync) ysu. ce
yid, o701.
CONSTRUCTION INFORMATION:
itiona wor to e e orme under tispermit—checka apply:
11HVAC F] Gas Tank Gas Piping _ Shutters ❑ Windows/Doors
11 Electric 0 Plumbing []Sprinklers Generator 0 Roof
Total Sq. Ft of Construction:
Cost of Construction: $ $00
SgI_F_t_.I of First Floor: _
Utilities: lSewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ROBERT M./LEAH N. REALS
Name: JOHN M. MAY
Address: 5180 NW DUNN ROAD
Company: JM CUSTOM POOLS INC
City: FORT PIERCE State: FL
Zip Code: 34981 Fax:
Phone No.
Address: 2503 DYER ROAD
City: PORT ST. LUCIE State: FL
Zip Code: 34952 Fax:
Phone No. 772-240-3268
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner'listed above)
E-Mail: jmcustompoolsinc@gmail.com
State or County License: CPC1458456
If value of construction is $2S00 or more, a RECORDED Notice of Commencement is required.
'SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: M. RANDALL RODGERS
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address: 1801 HAZELWOOD DRIVE
Address:
City: FT. PIERCE State: FL
Zip: Phone: 772-201-1634
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY:
Name:
_Not Applicable
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
commencing work or recording vour Notice of Commencement.
-Agent/ Lessee
STATE OF FLORIDA
COUNTY OF ST. LUCIE
The fRMping instqffnent was acknowledged before me
this day o 20Vby
(Name of pqson acknowledging)
State of
Personally Known y OR Produced Identification
Type of Identification Produced
c�al fNot _
IN Kwliin Ju NW a1PbIkA a;YNe, F" ' ry Public State of
STATE OF FLORIDA
COUNTY OF ST. LUCIE
The forgoing instrument was acknowledged before me
thisto o dayof -'JGlNE 20�U by
JoA)s ►M-MAY
(Name of person acknowledging)
if
(Signature of Notary PGb/lic-State of Florida )
Personally Known W_ OR Produced Identification
Type of Identification Produced
No. � 33 76 (Seal)
j "'�""� ��� ' rviy Commission G6 YOS981 Expires 10/0312023 '? o,AM
: MY COMMISSION # GG093576
EXPIRES April 12, 2021
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