HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPL i ED FOR APPLICATION.TO BE ACCEPTED ^7
-.Data:_ �• l o�• �7• Permit Number: I I � �
p Building Permit Application OCT 1 �
Planning and Development
11
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
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Legal Description: JG��S ��S-�� l,1JT 2-
Property Tax ID#: 2-3 _ o, 6 1 - 0 cc)-- Q )- Lot No.Site Plan Name: Block No.
Project Name: tuy-4-h
Setbacks Front Back: Right Side: ��r Left Side: ��Z
Installation of Gunite Pool, Deck and Equipment
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itiona wor to e e orme�N uriier t is perm -c ec a a app y: ..
�HVAC �GaS Tank ❑Gas Piping _Shutters �Windows/Doors
Electric !r J Plumbing Sprinklers Generator Roof
Total Sq.Ft of Construction:PQec _37 6 f4- S . Ft.of First Floor:
Cost of Construction:$ _33 , c7 Utilities: Sewer Septic Building Height:
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Name J6,SNACk.. Name: TerryWix
Address:.5-ZG� ` l. I"F4 Z b Company: Pools by Greg, Inc.
City: ro4i- State: L Address: 8886 S Federal Hwy
Zip Code: �4/�I y Fax: City: Port St Lucie State:FL
Phone No. Zip Code: 34952 Fax: 772-337-9287 j
E-Mail: I Phone No. 772-337-9713
Fill in fee simple Title Holder on next page(if different E-Mail: office@poolsbygreginc.com
from the Owner listed above) State or County License: CPC1458338
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If value of construction is$2506 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _/�' _Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: � 7 Iv 1 Cs Name:
Address: - / c C. Address:
City: W• P. 9 State: I-L- City: State:
Zip: J,3qll _Phone: ,-?— S-- 7 9—(oSN� Zip: Phone:
FEE SIMPLE TITLE HOLDER: X 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.
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_Signature of O /Lessee/Agent Signature of Co #tor/Lic nse Holder
STATE OF FLORIDA / STATE OF FLORIDA "
COUNTY OF 3 -- lit C�l_i COUNTY OF � lti .l
The forgoing instrumen was acknowledged before me The forgoing instrument was acknowledged before me
this'j—day of 20 Eby this 3 day of dG ,20 _L1 by
Q I cl 11 y
(Na ne of perso cknowledging) (Nameo person ac�o ledging)
MWIM( IN"
i a ur oNotary Public-State of Florida) (Sig re otary Public- ate of Florida
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Personally Known OR Produced Identification Personally Known L�_ OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commissi Commission No. Seal
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4+; JAYME CHAVEZ
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"'v EXPIRES May 12,2020 0-
Revise ( o`'3. ,014 FloridallotaryService.com EXPIRES May 12,2020
(407).398-0153 FloridallolaryService.com
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DATE
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INITIALS
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