HomeMy WebLinkAboutBuilding Permit ApplicationAWAPPLICABLE INFO MUST BE COL'- n=iED FOR APPLICATION TO BE ACCEPTEr, v
Date:., 'a`� (U�C� V �, Permit Number: �® I ���
_ RECEIVED
Building Permit Application
Planning and Development Services DEC AA i-ra
Building and Code Regulation Division PemiM g; U,&partmaNt
2300 Virginia Avenue, Fort Pierce FL 34982 st• lh,rr"x, .,ounty
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Pool inground
PROPOSED IMPROVEMENT LOCATION:
Address: S379 -/--a i0T-RiL7jz_ nn ,,
Legal Description: 3 I 51b S a 0 / 0,4 Sv �5- D Ste' Vii d r SW
Vq- L.r; S5 60 3 0 �'— -1 S' oR 37ag - a l (EYV
Property Tax lD #: U D,9Q - 060 -6 Lot No.
Site Plan Name: Block No.
Project Name:'
Setbacks Front Back: Right Side: Left Side:
OETAILED DESCRIPTION .OF WORK:
CONSTRUCTION OF IN GROUND POOL WITH PA-Tl o .
CONSTRUCTION INFORMATION:
Additional work to be nerformed un er t is permit - c ec a app y:
I�HVAC Gas Tank Gas Piping _ Shutters Windows/Doors
11 Electric � Plumbing Sprinklers El Generator Roof
Total Sq. Ft of Construction:
Cost of Construction: $ G%D, OOd
S . Ft. of First Floor:
Utilities:USewer DSeptic Building Height:
"OWNER/LESSEE:
CONTRACTOR:
Name 511A ti
Name: JOHN M. MAY
Address:537 a ���� % oPT�ra ��—
Company: JM CUSTOM POOLS INC
City: F"o2T rP iE2c State: FL
Address: 2503 DYER ROAD
Zip Code: 3 495i Fax: --
City: PORT ST. LUCIE State: FL
Phone No.
Zip Code: 34952 Fax: 44
E-Mail:
Phone No. 772-240-3268
Fill in fee simple Title Holder on next page ( if different
E-Mail: jmcustompoolsinc@gmail.com
State or County License: CPC1458456
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CON'STRUC ,LIEN LAW INFORMATION: :
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name: M. RANDALL RODGERS
Name:
Address: 1801 HAZELWOOD DRIVE
Address:
City: Fr. PIERCE State: FL
City: State:
Zip: Phone: 772-201-1634
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
1 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 vour Notice of Commencement.
1 ���1
Signature of Owner/ ent/ LqtsVe Sign ture of C Icense Holder
STATE OF FLORIDA I STATE OF FLORIDA
COUNTY OF ST. LUCIE COUNTY OF ST. LUCIE
The fo Ing inst ment was acknowledged before me
thi�ay of �(�-,� ✓ 20by
of
Personally Known V— OR Produced Identification
Type of Identification Produced
Commission No.010%1 (Seal)
The forgoing instrument was acknowledged before me
this,,'3_dayof A/oo/Fu6A_P--,20_20by
L_�! A M. Alld I
(Name of person acknowledging )
(Signature of Notary Public- State of Florida )
Personally Known V/OR Produced Identification
Type of Identification Produced
Commission W4 � (Seal)
,,as+ NoUryPuftSuWofFlo M ;+off!""•�'' WILLIAM H DONOVAN JR
Revised 07/15/2014 AAN Ks�ylin J, May '`
�r My Commission GG 906961 "' '' MY COMMISSION # GG093576
_V.
7A _ � CV .ICCC. A.. :1 AA AAA.
REVIEWS
FRONT
COUNTER
pair
%PLANS
REVIEW
ANGROVE
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS