HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �J/)
Date: I- S •alp �I I Permit Number: GL
RECEIVED
Building Permit Application APR 3 0 2021
Planning and Development Services Pgrmittasg Department
Building and Code Regulation Division St. Lucie County
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Pool inground
PROPOSED IMPROVEMENT LOCATION:
Address: 4906 BUCHANAN DRIVE
Legal Description: INDIAN RIVER ESTATES UNIT 1-BLK2 LOTS 7,8,9 AND 10 (MAP34/02N) (OR 3832-1309)
Property Tax ID #: 3402-602-0052-000-0
Site Plan Name: Blandford
Project Name: Pool
Setbacks Front Back: _
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
Lot No.
Block No.
CONSTRUCTION OF IN GROUND POOL WITH CONCRETE PATIO & WATER ALARM
CONSTRUCTION INFORMATION:
Additional work to be nerformed under this permit— check all t= apply:
❑HVAC 0 Gas Tank ❑Gas Piping _ Shutters ❑Windows/Doors
❑ Electric ❑ Plumbing ❑Sprinklers ❑ Generator ❑ Roof
Total Sq. Ft of Construction:
Cost of Construction: $
S Ft. of First Floor: _
UtilitiestSewer ❑Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameALAN/MELISSA BLANDFORD
Name: JOHN M. MAY
Company: JM CUSTOM POOLS INC
Address: 4804 Palmeto, Drive
City: Fort Pierce State: FL
Address: 2503 DYER ROAD
City: PORT ST. LUCIE State: FL
Zip Code: 34982 Fax:
Phone No.
Zip Code: 34952 Fax:
E-Mail:
Phone No. 772-240-3268
Fill in fee simple Title Holder on next page (if different
E-Mail: Jmcustompoolsinc@gmail.com
from the Owner listed above)
State or County License: CPC1458456
If value of construction is $2500 or more, a RECORDED Notice of commencement is regwrea.
SUPPLEMENTAL'CONSTR ION LIEN,LAW INFORMATION
..
.DESIGNER/ENGINEER:. _ Not Applicable
pp
MORTGAGE COMPANY: _ Not Applicable
Name: M. RANDALL RODGERS
Name:
Address: 1801 HAZELWOOD DRIVE
Address:
City: FT. PIERCE State: FL
City: State:
Zip: Phone: 772-201-1634
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ 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
'codnmencine work orrecordine vour Notice of Commencement.
STATE OF FLORIDA I
COUNTY OF ST. LUCIE
The f oing instr Tn w s ack owledged before me
this day of r 20AD by '
00 -ITa
(Name pf persgq acknowledging )
(SigrfatutePf N�ctaub)
Personally Known 1ry�
Type of Identification Prod
Commission
Revised 07/15/2014
r\�-M(
State of Florida-V
OR Produced Identification
Iced
IWWW'
r it Notary Public State of
Kaylin 7. May
+r A
Expires/0/0312023
o�
Signaffure of Contractor/Lic se Hold
STATE OF FLORIDA
COUNTY OF ST. LUCIE
The for oing instrument was acknowledged before me
this day of M A RCN , 20,U by
J 194,0 AV
(Name of person acknowledging)
(Signature of Notaryu c- State of Florida )
Personally Known t-�OR Produced Identification
Type of Identification Produced
m
WILLIAM H DONOVAN JR
EXPIRES April 12, 2021
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