HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE (INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /7► Q
Date: 12' '1 • l 9 Permit Number: I Q 12- l l 3 i T
Building Permit Application DEC o 9 2019
Planning and Development Services
Building and Code Regulation Division sT. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 9207 Champions Way, Port St Lucie, FI
Property Tax ID #: 3334-501-0086-000-9
Site Plan Name:
Project Name: Soriano
DETAILED DESCRIPTION OF WORK:
Inground gunite swimming pool
Screen Enclosure w/ Child Safety Barrier
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical
Electric
—Gas Tank
_ Plumbing
_ Gas Piping
_ Sprinklers
_ Shutters
_ Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 5 l7 0 0p + N Utilities: —Sewer _Septic
Lot No. 8
Block No. B
Windows/Doors
_ Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Mark J or Lyn D Soriano
Name: Wade M Clarke
Address: 30 Somerset Drive
Company: Horizon Pools Inc
City: Holbrook, NEW YORK State: _
Zip Code: 11741 Fax:
Phone No.
Address: 5423 Stately Oaks St
City: Ft Pierce State: FL
Zip Code: 34981 Fax:
Phone No 77a, 31 1—�51 O
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mailhorizonpools,sandy@gmail.com
State or County LicenseCPC1458644
If 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.
UPPI.EMENTAL CONSTRUCTION LIEN LAW.INFORMAT(ONe.
DESIGNER/ENGINEER: _ Not Applicable
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MORTGAGE COMPANY: Not Applicable
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Name:
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Zip: Phone:
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SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: Not Applicable
ame:
Name:
�{ddress:
Address:
City:
City:
Phone:
Zip: Phone:
Zip:
011%VVVNER/ 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. I`Fucie County makes no representation that Is granting a permit N�III authorize the permit holder to build the subject structure
ation rues, wh ch is in conflict with any applicable Home Owners Associes, byllaws or anScovenants that may restrict or prohibit such
structure. Please consult with your Nome Owners Association and review your deed for any, restrictions which may apply.
In tonslderation of the granting of this requested permit, I do hereby agree thatd will, ln::all respects, perform the work
In zccordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications areexempt from undergoing a full concurrency review: room additions,
acclessory 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 WE JOB SiTE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WiTH YOUR UENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OFCOMMENCEMENT "
Si na ur caner Lesse�e� /Contractor as Agent for Owner Slgnature.ofCo tractor/License Holder
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5'','''jjjATE OF VLOR" STATE OF FLORIDAG 1 / `�
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CpUNTYOFSU/J�L/L COUNTYOF Jam/ C/
fl, aY instrument was acknowledge fore me The fo, ,going instr ent was acknowledged -before me
> trill ."of 5.1/L. /�L�i.20 by this TIC�lday of 204 by
Name of.persan_makingstatement. ante of person making statement.
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Peirs9nally l(nown OR.Produced Identification Personally Known Produced Identification
Ttipe-of Identification
Type of Identification
Produced' Produced J9san(iaA1174121011
NOTARYPIYeub
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($IgnatureDEdlolItew5ate of Florida) (Signature of Notary Pu - tat t
Notary Public, State
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Expires41t8/2022
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
CbMPLETED
e.