HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE W 0 MW BE COMPLETED FOR APPUCAMON iM BE ACCEPTEf7
Date' Permit Plumber, 10� t J
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8uildin Permit Application
Planning and Cleve% ment.Servrces
Building:and Code R ulddon.Divisian
23oo trirginfa Avenu Fort.Pienz FL 34982
Phone;(772)462 sa Fa=(i22)462-2s7s: Cori'tmerdal Residential X.
PERMIT APPti TION:FOR: pool inground
a _ - -
Address: 5
Legal.Descrription, ftYANIW
Prope V Tax lD#:. 0, Lot No.
site P$n Name:, ' Block No..
Project ldaine: ,t
Setbacks Front BaCICI1 ' Right Side: ' J Left Side:
InsWiation of Gu Ito Pool,`Deck and Equipment -
WE w
tone I wor twCO rformeaunder MIS permit—cftecK all IM apply:
HVAC Gas Tanis E]Gas Piping Shutters O WindowVDOors
LD'Ele-ctric L!i Plumbing IDSprinklers Q Generator Roof
Total Sq.Ft of Gan uch(a�nrr� .Ft.of FiM''Fll000r.
Cost of Construction $cl cl , n Utilities Sewer Fleptic. Building Height
_ M Aw=
M
Name V_A,fP,(\ _ . ' � Warne:Terry VYoc -
Address: Company: Pools by Greg, Inc...
City: L State: Address: 8886 S Federal FIWX
Zip Cdde Fax, may; Port St Lucie State:FL
Phone No A Zip Code:M52 Fax;772=337.9287
E-lNaiii Phone No. 772-137-9743
Fill in fee simple Teti Holder on next page(if diffcamnt E Mail: office c—pooisbygcegirtc com
from the Ownec'}ist ' above) State or-County License: CPC1458M
If value of constructfo is$'2500 er more,a RKO[MW Nance of Commencement is reguirad.
I
I
' DESIGNER/ENGINEER. ^Not Applicable MORTGAGE COMPANII: Not Applicable
(Van1e:M.Rnwoai.►_RocERs Name: i
Addre55'1aoltiA2ELw000CtRNE - AddreSS'
City. FORT PIERCE FL
• State: City: State:
Zip: 34982 Phonen2201-16u .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 your Notice of Commencement.
Signature of.qwnfir/Lessee%Contractor as Agent for Owner Signature of Cosi&iictor/Lice se Holder
STATE OF FLORIDA. D STATE OF FLORIDA
COUNTY OF � ��a(�1 "L COUNTY OF �Z C
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this wday of_ _ J\_1.AQ 20a by this-L!5 day of ylu" 20 911 by
TERRYWIX TERRYWIX
Name of person making statement, Name of person making statement.
Personally Known -4 OR Produced Identification Personally Known �_/— OR Produced identification
Type of Identification Type of Identification
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 ,�*° oT y Public State f Florida
ev. c My Commission GG 201733 < ta*v t'°bt Sta -d to
Ada
F�cpiTes 0312912422 t A Tbomasina BoMns
c My Corrunisston GG 201733
z; asn Expires 03/29J2022