HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMVLr i ED FOR ArPLI'C-ATIONITO BE ACCEPTED ` )
Date:I � —) 1 .Permit Number: 1 ��� � 0
Building Permit Application RECEgV
Planning and Development Services
Building and Code Regulation Division DEC 1 6
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Pool inground
Address: y '
Legal Description: V
Property Tax ID #:
Site Plan Name: U
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Ili' 1'ti 11 N
Project Name: L U 1 1-1 t i U —U r yg I «a V V I I u 1
Setbacks Front Back: 10. Right Side: 7 Left Sided
Lot No._
Block No.
Additional work to be ertormed under this permit —check all apply:
�HVAC 11 Gas Tank Gas Piping _ Shutters a Windows/Doors
Electric Z'Plumbing Sprinklers Generator Roof
1� I4-.1
Total Sq. Ft of Construction: I-P S . Ft. of First Floor:
Cost of Construction: $8. Utilities: ] Sewer El Septic Building Height:,
Name STANDARD PACIFIC OF FLORIDA
Address: 825 CORAL RIDGE DRIVE
City: CORAL SPRINGS
State: FL
Zip Code: 33411 Fax:
Phone No. 561-969-2299 Ext.407
E-Mail: construction@fountainbluepools.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: JOSEPH B. HOLSTON
Company: FOUNTAIN BLUE POOLS
Address: 2731 VIST PARKWAY SUITE D-1
City: WEST PALM BEACH State: FL
Zip Code: 33411 Fax:
Phone No. 561-969-2299 Ext. 407
E=Mail: construction@fountainbluepools.com
State or County License: CPC 1458019
I
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not Applicable
Name: MARK E. WEBER (LICENSE # 53895)
Address: 6810 NORTH STATE ROAD 7
City: COCONUT CREEK State: FL
Zip: 33073 Phone: 954-617-8143
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
Not Applicable
MORTGAGE COMPANY:
Name:
Address:
Citv:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
State:
Not Applicable
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 r suit in your paying twice for
improvements to your property. A Notice of Commencement must be recor a and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with le de or an attorney before
commencine wofVovfkcordina vour Notice of Commencement. _
_ Signature of Owner/ Lessee/Agent
Signature of Coffractor/L]y6nse Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF �,�' /� COUNTY OF
The for og�yg instrument was acknowledged before me
this ''`day of 20,by
SSTEVEN DASSA-
(Name of peon acknowledging
The forgoing instrument was acknowledged before me
thisyr" day of P;�G - 20 "by
JOSEPH B. HOLSTON
(Name of persgn acknowl
s
4
" " �//i Si nature of Notary IFc-" f f of Florida
(Signature o otaWPuba e o IGG �(g y Personally KnownR u g ° ton Personally Known rodu`�i Id Type of IdentificatQ� �N : �= — Type of Identificati Produc d �����•.
Commission No, Commission No. _'�: (Seab}.� ;*
_ �g�pt .
y 4 : d ¢ = OGG 124701
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Revised 07/15/2014 //���pii iio���\\\\\` '//��e��
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