HomeMy WebLinkAboutBuilding permit appALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue Fort Pierce Ft 34982
Phone: (772) 462- 53 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION
FOR: Pool inground
O 11
RIP
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Address; -76D
5 E
Legal Description:
W1Qt`j \ !)Lob9,
Property Tax I #:
Lot No.�
Site Phan Name:
Block No.
Project Name:
Setbacks Front
Back:" Right Side: Left Side:21W 6p
Installation of Gu
ifte Pool, Deck and Equipment
wor o
e e orme un er t �s permit — c ee a app y:T
��t(fona
HVAC
OH
Gas Tank ❑Gas Piping Shutters Windows/Doors
Electric
0 Plumbing E]Sprinkters Generator t=1 Roof
Total Sq. Ft of Const
uction: tf_V, (.Q()1� S . FtFt. of First Floor:
Li`
Cost of Construction
$ , b utnities: L�J Sewer I] Septic Building Height:
- 3 r;:
o.
Name' 'It
Name: ferry vvm
Address: i
6 S Company: Pools by Greg, Inc.
City: f 'Jt
AW I State: FAddress: 8886 S Federal Hwy
Zip Code:
Fax: City: Port St Lucie State: FL
Phone No. �I 1
Zip Code: 34952 Fax: 772-337-9287
E-Mail:
Phone No. 772-337-9713
Fill in fee simple Title
Molder on next page (if different E-Mail: office@poolsbygreginc_com
from the Owner listed
above) State or County License: CPC1458338
if value of constructio
is $2500 or more, a RECORDED Notice of Commencement is required.
i
DESIGNER/ENGINEER: _ Not Applicable
Name. M. RANDALL ROGERS
Address:1801 HAZELWOOD DRIVE
City: FORTPIERCE State: FL
Zip: 34982 Phone772-201-1634
FEE SIMPLE TITLE HOLDER: — Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: — Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Pho
,Not Applicable
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
rornmencing work or recordine your Notice of Commencement.
Signature of r/ Lessee/Contractor as Agent for Owner
Signature of Co th�i ctor/Lic 'se Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF ht IA I r,1�
COUNTY OF
The fo oing instrument was acknowledged before me
[�
The for oing instrument was acknowledged,pefore me
T day ptc— 20 90by
this day of 20_Xby
this of
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 Identificatio
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
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Diary Public State
f Florida
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