HomeMy WebLinkAboutPERMIT APPALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
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OW
�-WW
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
Address:
Legal Description:
Property Tax ID #: ..I':r0 z
Site Plan Name:
Project Name: 1 ["YY UUU -
Setbacks Front Back: � D Right Side:
Installation of Gunite Pool, Deck and Equipment
❑airionai work to e e ormeff-
11HVAC Gas Tank
Electric Z Plumbing
r Inis Dermit —
Piping
Sprinklers
Left Side:
L =.1 Shutters
IGenerator
Total Sq. Ft of Construction: Q' 7�
—�--•---�� S . Ft. of First Floor: _
Cost of Construction: $ Utilities- Sewer Septic
Address:
City' EL
State:
Zip Code: a Fax:
Phone No.��?j•'� (�C(
E-Mail•
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Lot No.Obq
Block No.
QWindows/Doors
0 Roof
Building Height:
Name: Terry W►x
Company: Pools by Greg, Inc.
Address: 8886 S Federal Hwy
City: Port St Lucie
State: FL
Zip Code: 34952 Fax: 772-337-9287
Phone No. 772-337-9713
E-Mail: office@poolsbygreginc.com
State or County License: CPC1458338
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
i
DESIGNER _Not Applicable
MORTGAGE COMPANY:
N a m e: M. RANDALL ROGERS
_ Not Applicable
Name:
Address: t801 HAZELWOOD DRIVE
Add
A ress:
City; FORT PIERCE State; FL
Zip: 34982 P h o n e 772-201-1634
State:
Zip: Phone.
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
n%A/IUGR/rnRiTDAI"TAn Ar-r-im i .
----•-�. I ... - V1%Mrr1UV11; 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
commencing work or rec ing your Notice of Commencement.
i
Signature of 0 r/ Lessee/Co- ractor as Agent for Owner ;Signature of o ractor/Lice se Holder
STATE OF FLOR STATE OF FLORID .
COUNTY OFT COUNTY OF
The for ng instr t was acknowledged before me
this day of 2012 by
TERRY WIX
Name of person making statement.
The ing instr�aTt t as acknowledged,, before me
for
this day of 20 by
TERRY WIX
Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identificati
Produced Type of IdentificaY n
Produced
(Signature of Notary Public- State of Floridaa
)* (Signature of Notary Public- State of Florida )
Commission No.
(Seal)
Commission No.
(Seal)
REVIEWS
FRONT
COUNTER
ZONING SUPERVISOR
REVIEW
PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW
REVIEW REVIEW
REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
YA4v
Nota Public State
!OThomasina
Bowins�
My Commission GG 201733
M asina Bowins
Y Commission
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4*1 Of
Expires 03I29/2022
GG 201733
Expires 03/29l2022
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