HomeMy WebLinkAboutBuilding permit app111 APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number
Date -
�7:L1!�LL
Building Permit Application
Plonnog and Development Services
Commercial Residential x
Building and Code Regnlotlon Division
23oo virgmlo Avenue, Fort Pierce FL 34982
Phone: (772) A62-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: _
PROPOSED IMPROVEMENT LOCATION: —I
8612 Cobblestone Drive
Address:
Property Tax ID R: 2326.600-0074-000-8 Lot No.69
June ___ Block No. — -
Site Plan Name: -
Project Name:
DETAILED DESCRIPTION OF WORK: --- _-
Inground swimming pool wisaeen enclosure and splash guard alarm
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters —Windows/Doors —Pond
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor —
Cost of Construction: S Utilities: _Sewer _Septic Building Height.
--
OWNER/LESSEE
cpNTRAETOR .
Name June. Edward A, Jr 8 Karen H Name: wade M Clarke
Address:8612 Cobblestone Dr Company: Horizon Pools Inc.
City_ Ft Pierce State: _ Address: 5423 Stately Oaks Dr
Zip Code: 34945 Fax: C;ty, Ft Pierce State: FL
Phone No. Zip Code. 34981 Fax:
E-Mail: Phone No 772-405.1130
Fill in fee simple Title Holder on next page (ff different E-Mall horizonpools.sandy@gmaii.com
from the Owner listed above) State or, County License CPC1458644
If value of construction is 2500 or more, a RECORDED Motto of commencemem is required.
if value of HAVC Is $7,SOD or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: _
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: a 4,
Address:
City: e,„;. State:.
Zip. s.aet Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Address: Address:
City: I 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 aws or permit holder to build the subject structure
structure. Please coict nsult th with pyourr Hle Home Owners ome Owners Association Association
andrreview your deed for any restrictions nants that wh which may arestrict or pply
such
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-resoential use
WARNING TO OWNER: your failure to Record a Notice of Commencement may result in paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before c_ommencinR work or recor in our Notice of mencement.
gnaturofLessee/Cor'trartor as Agant for Owner Signature of Contractorlucense Holder
— STATE OF FLORIDA '
STATE OF FLORIDA C 1 I , . „ COUNTY OF .44- I6a f e
COUNTY OF Jf� t-L.(.l_.-1
Swo�Yto (or affirmed) and subscribed before me of
Physical Presence or _ Online Notarization
tms __ day of 2020 by
K&Re r- &mga
Name of person making statement.
Personally Known ✓ OR Produced Identification
Type of Identification
(Si ature of Notary Public- State orida )
Commission Na_ fa Ingraham
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DATE_._ _
RECEIVED
DATE
COMPLETED
ev. 516/10
Sworr Ioraffirmed and bscribed before me of
A"
t zeal Prg�.r'u Online Notanzation
ay of� 2020 by
Name of person making statement.
Personally Known OR Produced Idemlficauon
Type of identification
(Siefre of Notary Publa'State of P Iosandra A. In
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CommiuionNo. _ _ _ t NOTARY PLA
STATE OF Fk
PLANS VEGETATION SEA
REVIEWIREVIEW j REVIEW IME