HomeMy WebLinkAboutBuilding Permit ApplicationAIJ,_AR_PL1.CABLE INFO MUST BE COMPC,_ =1) FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: tt-o 559
' RECEIVED
Building Permit Application NOV 2 6 '.919
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 APPLICATION FOR: Pool inground
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Address: aju _ 3 �-}-x
Legal Description: Y I� ��(' If(Q_ t �
Property Tax ID #: 1°J I ' S Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: 1 !AT t Side:--tL�l� Left Side: 19-7
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Installation of Gunite Pool; Deck and Equipment
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Additional work to be Dertormed under tis perm — check all apply:
F1HVAC L_J Gas Tank ❑Gas Piping _ Shutters Windows/Doors
Electric Lr 11 Plumbing Sprinklers Generator Roof
POO *' 3310
Total Sq. Ft of Construction" A^ - ,. (o1v3 S . Ft. of First Floor:
Cost of Construction: $ ��)�� UtilitiesInSewer Septic Building Height:
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Name: Terry WN
Company: Pools by Greg, Inc.
Name Pm 1',C�Iwyyd Nui I I
Address: cDgm g
r1
City: Pb Stater
Address: 8886 S Federal Hwy
City; Port St Lucie State: FL
Zip Code: _ i Fax:
Phone No. �o�' o`Z'"[�3y
Zip Code: 34952 Fax: 772-337--9287
E-Mail:
Phone No. 772-337-9713
E-Mail: office@poolsbygreginc.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State or County License: CPC1458338
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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 lender or an attorney before
commencingwork or recor in our Notice of Commencement.
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=LIEN,�LIAW��I}NF�ORMATIONr
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DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
N a m e: M. RANDALL ROGERS
Name:
Address:,eo, HAZELWOOD DRIVE _
Address:
City; FORT PIERCE State; FL
City: State:
Zip: aa982 Phonenz-zo,-,eaa
Zip: .Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip:, Phone:
Zip: Phone:
Signature of O n Lessee/C "tractor as Agent for Owner
Signature of Co ra or License I
r
STATE OF FLORIDA 11
STATE OF FLORIDA
COUNTY OF S'}' l
COUNTY OF
The forgoing instr ment was acknowledged before me
The forgoing instrument was acknowledged before me
this � day of ����ln�n�.r . 20� by
this 8 day of IVO�I�iiYl{�Y , 20JG� 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 � Notary Public State c1 Florida
Sabrina M Arrington �
Notary Public Stateof Florida
Sabrina M Arrington
My Commission GG 9p827:�
�
My Commission GG 908279
�j4 �� Expires 08I27I2023
�a Expires 08/27IZ023
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(Signature Of Notary Pub
(Signature f Notary Public- State of Florida )
Commission No. (Seal)
Commission No. 21 � (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
�
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
rl�Z,1
RECEIVED
DATE
COMPLETED