HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE
Date:
Planning and Dew
Building and Code
2300 Virginia Aver
Phone: (772) 46e
PERMIT APPLli
Address: a
Legal Description:.
Property Tax ID #:
Site Phan Name:
Project Name: _
Setbacks Front
Installation of
MLiST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Building Permit Application
mentservices
rulotion Division
Fort Pierce FL 34982
53 Fax: (772) 462-1578
Commercial Residential X
TION FOR: Pool inground
Back: � Right Side: �a t Left Side:
ite Pool, Deck and Equipment
OHVAC Gas Tank ❑Ga!
Electric T�acn:
Plumbing 0Spi
Total Sq. Ft of Con 0: K jam- i
Cost of Construction $
Na
City: r1✓ Y I Y '
Zip Code:eNq 1�
Phone No.1
E-Mail:
Fill in fee simple Tit
from the Owner list
Lot No-4.
Block No. —71
,5
nu—LnecKall Mutters
ply:
Piping El"` windows/Doors
nklers F� Generator t�i Roof
Sq. Ft. of First Floor: _
Utilities: Sewer Septic
State:-S- L
Fax.
. ,i
Holder on next page ( if different
I above)
Building Height:
Name: Terry Wix <
Company: Pools by Greg, Inc.
Address: 8886 G Federal Hwy
City: Port St Lucie
State: FL
Zip Code: 34952 Fax: 772-337-9287
Shone No. 772-337-9713
E-Mail. office@poolsbygreginc_com
State or County License: CPC1458338
If value of constructio is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable
Name: M. RAN DALL ROGERS
1 Name:
Add ress: 1801 HAZELWOOD DRIVE Address:
City: FORT PIERCE State: FL City:
Zip: 34982 Ph one 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:
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
structure. Please
restrict or prohibit such
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 the Florida Building
plans, 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 Cr/ Lessee/Contractor as Agent for Owner
Signature of Co ctor/Lic `se Holder
1
STATE OF FLORIDA
COUNTY OF 6k 111-C.)
STATE OF FLORIDA
COUNTY OF tA)
The forgoing instrument was acknowledged before me
this �1_ day of
The forgoing instrument was acknowledged before me
20 M by
this .1 day of 3 1 a 1 i 20i by
TERRY WIX
TERRY WIX
Name of person making statement.
Name of person making statement.
Personally Known 'IC- OR Produced Identification
Personally Known Y_ 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
COMPLETEDi otary Public State fFlorida,
Rev.
.^ v My Commission GG 201733 e Of orida
d Expires 03/29/2022
°r e A Thomasina Bowins G
r: ` My Commission GG 201733
W of Expires03/29/2022