HomeMy WebLinkAboutBuilding Permit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: _
S"o LLUCLE,
-)I J J 6".
5 `� �_r Building pp 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:
1 PROPOSED IMPROVEMENT LOCATION:
Address: 53Y ' S �55T
Residential YES
PropertyTaxlD#: 3 05- c 1-bDDa - o-3- Lot No._
Site Plan Name: _row So LID f Block No.
Project Name: Lot -ICE NP_W Pool
DETAILED DESCRIPTION OF WORK:
NEW IN GROUND POOL
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
lectric '_> Iumbing _Sprinklers _Generator
Total Sq. Ft of Construction-
Cost of Construction: $--I , Qa�D
OWNER/LESSEE:
Sq. Ft. of First Floor:
Windows/Doors
Roof
Pond
Pitch
Utilities: —Sewer —Septic Building Height: _
Name �4 - 4-o c/Ce
Address: 5 3H 5 15, 2 5 `Ln S+&P-t
City: FT PIERCE r State: JL
Zip Code: ��q991 Fax:
Phone No. dal) G/3& - 3UO%
E-Mail:8joc to g 1 �+�,r►�j -
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: WARREN SIGMAN
Company: FLORIDA LIFESTYLES POOL
Address:1469 SW BALMORAL TERR
City: STUART
Zip Code: 34997 Fax:
Phone No772-237-7665
State: FL
E-Mail OFFICE@PROPPOLBUILDERS.NET
State or County LicenseCPC1457647
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 INFORMATION:
DESIGNER/ENGINEER:
Na me: MARKHAM SERVICES INC (57216)
Address: 1820 NE JENSEN BEACH BLVD #685
CItV: JENSEN BEACH
Zip: 34957 Phone954-941-1124
FEE SIMPLE TITLE HOLDER:
Name:
Address:
Citv:
Zip: Phone: —
Not Applicable
State: FL
X Not Applicable
MORTGAGE COMPANY:
Name:
Address:
Citv:
Zip: Phone:_
x Not Applicable
State:
BONDING COMPANY: x Not Applicable
Name:_
Address:
City:
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.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF STLUCIE
of Contractbi`71_icense Holder
STATE OF FLORIDA
COUNTY OF STLUCIE
Sworn to (or affirmed) and subscribed before me of Sworn (or affirmed) and subscribed before me of
Physical Presence or Online Notarization Physical Presence or Online Notarization
this a5- day of , 202Q by this tj� day of 2021 by
J2ADL r La�K-E _j,�� r� �n� o�•. S; vv�a-�
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 1)1-- Produced
(Signature of Notary Public- %ale� pLFjo i. (Signature of
Public- State of Florida )
�tr No Py{hlic Stale of Florida
Commission No. ° Ke% { son Commission No.
'y�rjMy Commission GG 950217
Expires 0112212024
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATI
COUNTER REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Notary Public kWpW Florida
rry A Sisson
i My Commrssion GG 950211
°A'fQ VE
REVIEW REVIEW