HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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
PERMIT APPLICATION FOR: Pool inground
Y
PRO] 4K
Address: 1
_
Legal Description: i
)L� e�J aim 1 Lot No.�—
#:'1"
Property Tax ID d
Site Plan Name: i�9ri��� Block No.
Project Name: 1�
Setbacks Front Back: Right Side: Left Side:
t
F-DETAILED:DESCRIPTION OF WORKiml. 3
ri'�5b g���9`{5.b Ai,`"aY'!
Installation of Gunite Pool, -and Equipment
�CTditiona wor to e e ormeTun�c er tTis permit — c ec a t a app y.
� � Q
❑HVAC Gas Tank Gas Piping Shutters Windows/Doors
Electric Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction:` J J� Sq. Ft. of First Floor:
$"�:7,_
Cost of Construction: Q� -� Utilities: E Sewer _Septic Building Height:
OWNER/LESSEE. ;
CONTRACTOR:
Name
Name: TerryWix
Company: Pools by Greg, Inc.
Address:
City: State:
Address: 8886 S Federal Hwy
City: Port St Lucie State: FL
�y1
Zip Code: Fax:
Phone No.
Zip Code: 34952 Fax: 772-337-9287
E-Mail:
Phone No. 772-337-9713
Fill in fee simple Title Holder on next page ( if different
E-Mail: office@poolsbygreginc.com
State or County License: CPC1458338
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER:
N a m e: M. RANDALL ROGERS
Ad d re ss : 1801 HAZELWOOD DRIVE
('if V- FORT PIERCE
ICTION LIEN LAW INFORMATION:
Not Applicable MORTGAGE COMPANY: Not Applicable
Name:
Zip: 34982 Phone772-201-1634
State: FL
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:_
Address:
City: State: _
Zip; Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
_Not Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit To ao Lilt wui rc aiiu 111,1L0 0U 11 a�
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
structurin e. conflict
lease consulth t with pyolur Hle Home Owners ome Owners Association Association nd review bylaws ur deed ffor any restrictions nts that wh which restrict
may aly. prohibit such
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 recoruln uui I11JI.R.C: U1 • ���������
��
Signature of Orn r/ Lessee Contractor as Agent for Owner
Signature o ntractor License Holder
STATE OF
OF ORID�LC 1
COUNTY OF ��a�
COUNTY OFSTATE
COUNTY
The for oing instru ent was acknowledged before me
The forgoing instr�.{ment was acknowledged before me
this � day of 20t by
this day of , 200" by
TERRY WIX
TERRY WIX
Name of person making statement.
Name of person making statement.
Personally Known 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
REVIEW
MANGROVE
REVIEW
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev. wiu/16 L__r, I�W�IQDII�C ovvru ��
My Commission GG 201733
OF W
vsY a� Notary Public State of Florida LExpires 0312912022
aQ A Thomasina Bowins
My Commission GG 201733