HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COM
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FOR APPLICATION TO BE ACCEPTED
Permit Number: CQ 10 q - DA
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 �,r# PaT-1 U
PROPOSED IMPROVEMENT,LOCATION:
Address: 5812 PINETREE DRIVE
Legal Description: INDIAN RIVER ESTATES -UNIT 02- BLK 10 LOTS 19, 20 AND 21 (MAP 34/11 S)
Property Tax ID #: 3402-603-0118-000-4
Site Plan Name: CONDON
Project Name: POOL
Setbacks Front Back: Right Side: Left Side:
Lot No.19,20&21
Block No.
DETAILED DESCRIPTION OF WORK: `
CONSTRUCTION OF IN GROUND POOL WITH CONCRETE PATIO WITH FOOTER.
CONSTRUCTION INFORMATION:`
Additional work to bff
orme un er t is permit — c ec a apply:
�HVAC Gas Tank ❑Gas Piping Shutters
— Q Windows/Doors
Electric Plumbing OSprinklers 11 Generator Roof
Total Sq. Ft of Construction:
Cost of Construction: $
S Ft. of First Floor: _
Utilities:oSewer OSeptic
NameLYNN/PATRICK CONDON
Address:5812 PINETREE DRIVE
City: FORT PIERCE State: FL
Zip Code: 34982 Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:'-
Name: JOHN M. MAY
Building Height:
Company: JM CUSTOM POOLS INC
Address: 2503 DYER ROAD
City: PORT ST. LUCIE
Zip Code: 34952 Fax:
Phone No. 772-240-3268
E-Mail: imcustompoolsinc@gmail.com
I State or County License: CPC1458456
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
State: FL
"SUPPLEMENTAL CONSTRUCTIO ,
'N A,W`INFORMATION:
SIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name: M. RANDALL RODGERS
Name:
Address: 1801 HAZELWOOD DRIVE
Address:
City: Fr. PIERCE State: FL
City: State:
Zip: Phone: 772-201-1634
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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.
Inconsideration 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 recording vour Notice of Commencement.
ZZIJ-
IgnAurja Agent/ Lessee Sign ure of Contr or/Lice Holder
STATE OF FLORIDA
COUNTY OF ST. LUCIE
The forgoing instr ment was acknowledged before me
thi day of 20& by
acknowledging)
Public- Stite of Florida )
ersonall Know OR Produced Identification
Type of Identification Produced
Commission Noted Mk
Public State of
STATE OF FLORIDA
COUNTY OF ST. LUCIE
The forgoing instrument was acknowledged before me
thisday of :;;aC NZ . 20�U by
ON 0 Al . Al
(Name of person acknowledging)
�c
(Signature of Notary Public- State of Florida ) po r-A®V
Personally Known _� OR Produced Identification
Type of Identification Produced
Commission No.
My Revised 07/15/2014 '44Td; E PC ommission 0/03/2623 806981
(Seal)
vvllllam Menry Donovan Jr
My Commission HH 088457
Expires 04/12/2025
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