HomeMy WebLinkAboutAPPALL APPLICABLE I
Date:
Planning and Devi
Building and Code
2300 Virginia Aver
Phone: (772) 46:
PERMIT APPLI
Address: lQ e�Vb
Legal Description:
Property Tax ID #:
Site Plan Name:_
Project Name:
Setbacks Front_
Installation of G
MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Building Permit Application
vent Services
ulation Division
Fort Pierce FL 34982
53 Fax: (772) 462-1578
Commercial Residential X
TION FOR: pool inground
Back: -25.9 �5 ' Right Side: Left Side: - r l(2.
Pool, Deck and Equipment
---•-•--••--• --�• . �� c c.ivniiCli uriaertnis
pO— permit–check allffa50`rVY--::-
HVAC Gas Tank ❑Gas Piping hutte
rs
Rj Electric ' plumbing Sprinklers Generator
Total Sq. Ft of Consti uction: 1L Sq. Ft. of First Floor: _
Cost of Construction $ Utilities: Sewer n Septic
Name
City: Y'D I
Zip Code: -�
Phone No.
E -Mail:
Fill in fee simple
from the Owner
Lot No. 31
Block No. i
Windows/Doors
Roof
Building Height:
Al ',A1 'l,, Name: Terry W-
A R'�I� Company: Pools by Greg, Inc,
State: Address: 8886 S Federal Hwy
Fax: City: Port St Lucie State: FL
al I b Zip Code: 34952 Fax: 772-337-9287
Holder on next page ( if different
I above)
Phone No. 772-337-9713
E -Mail. office@poolsbygregina.com
State or County License: CPC1458338
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER. Not Applicable
� MORTGAGE COMPANY: _Not Applicable
Name ; M. RANDALL ROGERS
Name:
Address: 1801 HAZELWOOD DRIVE Address:
City: FORTPIERCE State: FL City: State:
Zip: 34982 Phone772-201-1634 Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Applicable
Name:
®Not
Name:
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, 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 Fender or an attorney before
commencing work or recording our Notice of Commencement.
f�
Signature o ner/ Lesse Contractor as Agent for Owner
Signature of tractor/ ense Holder
STATE OF FLORID
COUNTY OF � UU A
STATE OF FLORIDA
COUNTY t)A
OF
The forgoing instrument was acknowledged before me
this _a day of 5 20.Z by
The forgoing instru ent was acknowledged before me Q
this �� day of 20 by
TERRY WIX
TERRY WIX
Name of person making statement.
Name of person making statement.
Personally Known _ OR Produced Identification
Personally Known �— OR Produced Identification
Type of Identification
Type of Identification
Produced
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
DATE
RECEIVED
DATE
COMPLETED
ev.
tip9Y Wy Notary Public State of Florida
A Thomasina Bowins,.►XY °uW� Notary Public State of Florida
r M) commission GG 201733 A Thomasina BOwins
Expires 03/2912022 c My Commission GG 201733
c Expires 03129/2022