HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:J
Building Permit Application
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
`PROPOSED FIMPROVEMENT LOCATION r 4
_ _.. ... . ._ �._........__ .. .,....,_ .... 'i..... ........
Address: 3061 NW WWOFE WAY, PAW W Y. a 3DII)
Legal Description: @L&0D Pb w 4b LOT 4 7 0—Z M34- /Ocl Y
Property Tax ID#: q`l2 6-70.3 -005-2 -000-Y Lot No.
Site Plan Name: AMSALF—m EE50&jeE Block No.
Project Name: j'M SAgLEM eE51De)\10E
Setbacks Front Back: 515.) Right Side:3
0 Left Side:_I k4
RETAILEDDESCRIPTION'OF WORK = s Ef�
TiJGROUIJb 5WIMM(nJC P66L
Additional work
_to be nertormed' under this permit—check all apply:
E1HVAC 0 Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
ZElectric 0 Plumbing Sprinklers Generator F]Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ _75,00U,0d Utilities:"nSewer OSeptic Building Height:
OWNER/LESSEE _. a y tt ONTRACl"OR 4 N
Name r C p"Gi5 yan Figman
Address:: 3 O G t ��� cC-deb /��14?- Company: Apex Pavers&Pools
City: P'-&Ie l ef, State: )C7L Address --'M0Ai76e6Y R-D
Zip Code: 3W20 Fax: City: Stuart State:FL
Phone No. �(o l°Z— Kq 7 Zip Code: 34994 Fax: 772-5101
E-Mail: Phone No. 772-419-5151
Fill in fee simple Title Holder on next page(if different E-Mail: jscalise@apexpavers.com
from the Owner listed above) State or County License: CPC1458696
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SfiI��PlEMENTgL,CONSTRUCTION lIEN�tlA11�I�NFORMATION �, � ��,��-�- � � ��t � �� � ��._
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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
commencing work or recording our Notice of Commencement.
s
_Signature of Owner/Lessee/Agent Signat a of Con ra or/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF MA911d COUNTY OF HAV O
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 2 day of MAae N 20 l2by this day of AW 20 1 7 by
VIM -AmsALiA 2 ylqn1 0 6MAIJ
(Name of person acknowledging) (Name of person acknowledging)
dip—
(Signature of Notary Public-Stat Florida) Signature of Notary Pu ic-State Florida)
Personally Known J OR Produced Identification Personally Known --- OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission "+'ei''• E
ENJ.BU aI�13 Commission •`:d'•. eal
91
= SION# 288 , EEN J.BUF )MY COMMISSION#FF 928213January 3,2020. , EXPIRES:Janua 3,�%; Bonded Thru Notary Public underwriters
Revised 07 1572137--
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE `
COMPLETE III `l 11ej
INITIALS