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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: to. I 2-0 120 Permit Number: 2no(o - 01-tfi
Building Permit Applica in JuN 2 g 2020
Planning and Development Services Sr. Lucie County, permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT TYPE: CONSTRUCT NEW POOL
PROPOSED IMPROVEMENT LOCATION:13054 NWGILSON RD,, PALM CITY FL 34990
Address: 13054 NW GILSON RD., PALM CITY, FL 34990
Property Tax ID #: 4425-312-0020-000-1 Lot No.
Site Plan Name: ALEXANDER RESIDENCE Block No.
Project Name: ALEXANDER RESIDENCE
DETAILED DESCRIPTION OF WORK:'
CONSTRUCT NEW POOL (REFER TO CONSTRUCTION PLANS ATTACHED)
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I CONSTRUCTION' INFORMATION: - I
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
XElectric XPlumbing _Sprinklers _Generator
Total Sq. Ft of Construction: _
Cost of Construction: $ 67,800.00
Sq. Ft. of First Floor:
—Windows/Doors
_ Roof Pitch
Utilities: `Sewer _Septic Building Height:
OWNERAESSEEt
CONTRACTOR:
Name PAMELA ALEXANDER
Name: COLIN VANCAMPEN
Address:13054 NW GILSON RD.
Company: POOL PROFESSIONAL SERVICES, INC.
City: PALM CITY State: _
Zip Code: 34990 Fax:
Phone No.
Address.680 N. OLD DIXIE HWY
City: JUPITER State: FL
Zip Code: 33458 Fax:
Phone No (561) 262-1218
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail CLOUDON@BELLSOUTH.NET
State or County License CP01458038
it value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTIONLIEN LAW
DESIGNER/ENGINEER: Not Apolicable
Name
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
City:
Zip: Phone:
State:
BONDING COMPANY:
Name:
_Not Applicable
Address:
City:
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, 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of O'whL41VLVtkVe/Contractor as Agent for Owner
STATE OF FL
COUNTY OF.
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