HomeMy WebLinkAboutBuilding Permit Application CURRENTAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: v -COL.,
0
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:Swimming pool and patio
PROPOSED. IMPROVEMENT LOCATION:
Address: 1310 Copenhaver RD Fort Pierce, FL 34945
Property Tax ID #: 2313-123-0003-000-6
Residential X
Lot No.
Site Plan Name: Block No.
Project Name: Stahlberg Residence
DETAILED -DESCRIPTION OF WORK:
Gunite swimming pool, brick paver patio, and pool equipment
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION: :.
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters
Electric lumbing
Total Sq. Ft of Construction: 530 Sq. Ft.
Cost of Construction: $ 66,000.00
_ Sprinklers
_ Generator
Sq. Ft. of First Floor:
Windows/Doors
_ Roof
Utilities: _Sewer _Septic Building Height:
Pond
Pitch
OWNER/LESSEE:
CONTRACTOR:
Name Charlotte M Stahlberg
Name: Hannah .Becker
Address:1310 Copenhaver Road
Company:A&J Custom Pools LLC
City: Fort Pierce FL State:
Address:4911 Jorgensen Road
_
Zip Code: 34945 Fax:
City: Fort Pierce FL State:
Phone No. 772.267.7623
Zip Code: 34981. Fax:
E-Mail: anjcustompools@gmail.com
Phone N0772.539.3025
Fill in fee simple Title Holder on next page (if different
E-Mail anjcustompools@gmail.com
from the Owner listed above)
State or County License32304
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN' LAW -INFORMATIO'N .`
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: X Not Applicable
Name: Sidney Kovner
Name:
Address:
Address:139 isle Verde Way
City: Palm Beach Gardens State: FL
City: State:
Zip: 33418 Phone56.3864385
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
BONDING COMPANY: x 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County 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.
Signa ure df Owner/ Lessee/contractor-as Agent for Owner
Sign ture of Contractor/License older
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Saint Lucia
COUNTY OF Saint Lucie
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
X Physical Presence or Online Notarization
x Physical Presence or Online Notarization
this 26th day of .miy2021 12020 by
this 26th day of July 2021 .2020 by
Hannah Becker
Hannah Becker
Name of person making statement.
Name of person making statement.
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida
(Signature of Notary Public- State o
,,�rxr Pie •. IC ARWEN D ADAMS
Commission No.GG272920 =o. G r0agl�
`� ublic State of Florida
::o1�kY puBG,: ARWEN D AD
Commission No. GG272920 ?: Notary Public State
Commission # GG 272928
:I) Commission k GG 2
��`'
��?'`��� My Comm, Expires.pct
My Comm, Expires Oct 31, 2022
Bonded throuEh
National Notary Ass
.
I
S R
MANGROVE
REVIEWS
FRONT
PLANS
VEGETATION
SEA TURTLE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. .')/ t)/ LU
Assn.