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 Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: NEW IN -GROUND POOL BUILD
PROPOSED IMPROVEMENT LOCATION:
Address: 5766 PINETREE DR FT. PIERCE, FL 34982
Property Tax ID #: 3402-603-0112-000-2
Site Plan Name: SAMMLER
Project Name: SAMMLER RESIDENCE
DETAILED DESCRIPTION OF WORK:
NEW IN -GROUND POOL BUILD
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Lot No. 13 & 14
Block No. 10
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
✓Electric V Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 43,000.00
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name a,C
Address:
Name: Adam Hall
Company: Palm Pool and Spa, Inc
City: FT. PIERCE State:
Zip Code: 34982 Fax: (561) 792-0788
Phone No. (772) 370-7093
Address: 3141 FAIRLANE FARMS RD STE 2 WELLINGTON, FL 33414
City: WELLINGTON, State: FL
Zip Code: 33414 Fax:
Phone No (561) 792-5326
E-Mail: dsammler2006@yahoo.com
_
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail officeadmin@palmpoolspa.com
State or County License CPC1458139
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: x Not Applicable
Name:
MORTGAGE COMPANY: x Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone (561)792-5326
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
BONDING COMPANY: x Not Applicable
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 attornev before co encinia, work or recording k e of C mencement.
Si ature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLO 1
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STATE OF FLORIDAOwnR6&h
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COUNTY OF ,, tCOUNTY
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Swo to (or affirmed) and subscribed before me of
sical Pr or Online Notarization
Swo to Or affirmed) and subscribed before me of
sical Pr r Online N tarization
this tday of 202� by
this day of 202 by
Name of person making statement. /
✓/
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identifica '
Type of Identific '
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Produced �° PublicState of Floridary
Produced TONYAS.DHH
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Commission No. �"1 l (Seal)
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Rev. 5/6/20