HomeMy WebLinkAboutBuilding Permit Application r
ALL APPLICABLE IN&ONUST BE CON. �rED FOR APPLICATION TO BE ACCEPTED
Date: `U—/7 Permit Number:
ECR ®
Building Permit Application JANI 2 2017
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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 Residential X
PERMIT APPLICATION FOR: Pool inground
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Address: Ano
�egal Description: 44S 9-02%U a 3 ,q7- AA/7*eH TV 9(9 Al _cF-S-�4 IV
f1Pg-Yq-s) 40PS I 6A �a���Svste.7 0(2-36Y6 3g00-a03,i�)
Property Tax ID#: 2 53'1 - 603 -- 000o2 -- 000 Lot No.
Site Plan Name: tA)I Ce �!�0- Block No.
Project Name: /e/ N 1 ems!�C ,
Setbacks Front 6 0 Back: 41cl "3,Right Side: 4/4 Left Side: O / f
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Installation of Gunite Pool; Deck and Equipment
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i Iona wor o e e orme un er t is permrt-c ec a app y:
�HVAC �Gas Tank Gas Pi in _Shutters n Windows Doors
Electric W1 Plumbing Sprinklers Generator Roof
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Total Sq. Ft of Construction: _ S Ft.of First Floor:
Cost of Construction:$ Vie,6V Utilities Sewer Septic Building Height:
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Name G1 l el Name: Terry Wix
Address: /O �sl�wp l�ri,ue s COU Company: Pools by Greg, Inc.
City: �T2h %2h Be-a,Ch State:Oct- Address: 8886 S Federal Hwy
IZip Code: 2�f lF5$ 7 Fax: City: Port St Lucie State:FL
Phone No. '7' 9 If- 025 3 41 Zip Cade: 34952 Fax: 772-337-9287
IE-Mail: rrz y>�2_e11ay 'fm h Ce, eo o'y Phone No. 772-337-9713
Fill in fee simple Title Holder-on next page(if different E-Mail: office@poolsbygreginc.com
from the Owner listed above) State or County License: CPCI458338
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: HarveyEKoehnan Name:
Address:7205 Elyse Cir Address:
City: Port St Lucie State: FL City: State:
Zip;34952 Phone: 772-466-5509 Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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li 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 our Notice of Commencement.
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Signature o Ow er/Lessee Agent Signature of Co r r/License Holder
STATE OF FLORID 1 ' ' n STATE OF FLORIDA I
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COUNTY OF � COUNT. My a YOF
The folgoing instrum t was acknowledgep,before me The for ping instrume as acknowledged before me
this day of o2 20 by this of 20 1(aby
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(N me of persona owledging) (N a of person knowledging)
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atu of Notary Public-State ofFlorida) ( atur of Notary Public-Stat of Florida)
nally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identifica ion Produced
Commission No. (Seal) Commission No. (Seal)
�SI�Yp�4l:; JAYME CHAVEZ
Y•`= MY COM .
2014 '!�, EXPIRES May 12,2020 MY COMMISSION#FF991925
Revised 07/15/
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(407)398.0153 FiorldeNotaryservice.com % �,F; EXPIRES May 12,2020
(aFlarldeNotary5ervice.co
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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