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APPLICATION
Planning&Development Services Department Residential Pool Permit Checklist • When applying for a residential pool permit use the following checklist. ITEM HOW MANY? COMMENTS Building Permit 1 A completely filled out building permit application shall be Application submitted, including all required information. The application shall be signed by the applicant(s) and the signatures shall be notarized. If the applicant is the contractor/qualifier,the application requires 2 signatures. Notice of Commencement 1 A recorded Notice of Commencement for all construction with a value exceeding$2,500 shall be submitted prior to first inspection. Construction Plans 2 sets All proposed construction must be accurately shown on the plans including but not limited to electrical wiring, plumbing, and pool equipment detail. Both sets of plans shall be signed and sealed by a Florida registered engineer or Architect Plot Plans/Surveys 2 2 Scaled Plots Plans with all dimensions of pool and deck area. Include location of pool equipment. Show setbacks of the pool/deck to all property lines and location of all existing structures. Form-board survey shall be required for poured concrete decks. Final survey shall be required for paver decks. Vegetation Removal Permit 1 A completely filled out vegetation removal application must be submitted with the building permit application. Please include one(1)survey or site plan, for review by the Environmental Resource Department. A specific plan for tree removal and preservation is required if applicable. Subcontractor Agreement I each One subcontractor agreement with original signature is required for each subcontractor on the job. The building permit cannot be issued until it has been determined that all subcontractors are properly licensed and registered.The use of unlicensed contractors is strictly prohibited. Filled Land Affidavit 1 This form is required for all construction, except for interior renovation. It shall bear the original notarized signature of the property owner. This affidavit serves to notify the property owner of their responsibility not to adversely impact their neighbor's properties with stormwater drainage and runoff. Pool Alarm Affidavit 1 Indicate the type of barrier/alarm. Shall be signed by property owner and notarized. ****An Application for a Pool Permit shall not be accepted without a Pool Enclosure permit application and plans or a fence permit(or proof of existing fence enclosing proposed pool area). Revised 9/10/18 All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: 1 - ."i•-� iY.wy�r 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 PERMITTYPE: PROPOSED IMPROVEMENT LOCATION: Address: 9415 BUNTING LN Property Tax ID#: 1334-502-0057-000-4 Lot No. 140 Site Plan Name: MONTE CARLO COUNTRY CLUB Block No. Project Name: SNOWE DETAILED DESCRIPTION OF WORK: INSTALLING GUNITES SWIMMING POOL WITH CONCRETE DECK CONSTRUCTION INFORMATION: Additional work to be performed under this permit—check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors x Electric x Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ 46,200.00 Utilities: —Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name JOHN&BETH SNOWS Name: TAMES T.LEONARD Address: 9415 BUNTING LN Company: A&G CONCRETE POOLS INC City: FORT PIERCE State: FL Address: 8880 GLADES CUTOFF RD Zip Code: 34951 Fax: City: PORT ST LUCIE State:FL Phone No. Zip Code: 34986 Fax: E-Mail: Phone No 772-R78-7752 Fill in fee simple Title Holder on next page(if different E-Mail HVTzzopANGPooIs. . M from the Owner listed above) State or County License CPC1457902 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: AAunN Ar r FNT Name: Address: 26377 7TH STREET Address: City: LA VERNE State: CA City: State: Zip: 91750 Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: 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 commencing work or recording our Notice of Commencement. Signature of Owner/Lessee/Contractor as Agent for Owner Si atur ontractor/License Holder STATE OF FLORIDA e STATE OF FLORIDA COUNTY OF ST LUCIE COUNTY OF ST LUCIE The forgoing instrument was acknowledged before me The forgoing instgrrl ,nt was acknowledged before me this A(�,day of 20'L\ by this I day of WkO,1120,11 by ►� Ste© JAMES T LEONARD Name of person making statement. Name of person making statement. Personally Known OR Produced Identification_) Personally Known x OR Produced Identification Type of Identification Type of Identification Produced DRIVER LICENSE roduced LLC+BAROCIO i ucy BAROQO Notary Public-State of Florid cr° fir' NOIdry Public•State of Pcrida �..; F `of Commission d GG 937274 .1 'P i Commission;GG 937274 My Comm.Expires Dec a,202 ` 'c ' My Comm,Expires Dec 4,2023 .......... Bcnded thrctgh N,-crai NCt3r`J A<_ _ BCnd@C lFrocgh`�at'cnai 4ca^�As,. (Signature of Nota lc-State cco11 lori a (Signature of Notary Public-State of Florida) Commission No. 312 `t (Seal) Commission No. g31Zw1y (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 5/6/20