HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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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 CBDG Funding
PERMIT APPLICATION FOR: IN-GROUND POOL AND PATIO
PROPOSED IMPROVEMENT LOCATION: 3054 NW. RADCLIFFE WAY
Address: 3054 NW. RADCLIFFE WAY PALM CITY, FL 34990
Property Tax ID#: 4425-703-0020-000-1 Lot No. 15
Site Plan Name: MANGO Block No.
Project Name: MANGO
DETAILED DESCRIPTION OF WORK:
IN-GROUND CONCRETE SWIMMING POOL AND CORAL STONE ON CONCRETE PATIO
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank ,Gas Piping _Shutters _Windows/Doors _Pond
_Electric _Plumbing _Sprinklers —Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ I^S'g yjC , — Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name_Mary Beth & Rocco Mango Name: MIKE ALEXANDER
Address: 3054 NW Radcliffe WAY Company: ALEXANDER CUSTOM POOLS
City: PALM CITY State: FL Address: 50 NE. DIXIE HWY (I-1)
Zip Code: 34990 Fax: City: STUART State: FL
Phone No. E- Zip Code: 34994 Fax: 772-444-3904
Mail. Phone No 772-444-3158
Fill in fee simple Title Holder on next page (if different E-MailALEXANDERCUSTOMPOOLS@HOTMAIL.COM
from the Owner listed above) State or County License CPC1457939
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: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: RANDALL RODGERS Name: _
Address: 1801 HAZELWOOD DRIVE Address:
City: FORT PIERCE State: . FL City: State:
Zip: 34982 Phone 772-201-1634 Zip: Phone:
FEE SIMPLE TITLE HOLDER: ,w Not Applicable BONDING COMPANY: _Not Applicable
Name: 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 conflicts with an applicable Homeowners Association rules,bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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 our Notice of Commencement.
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Signature of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF sT- -..._e--%-
Sworn to(or affirmed)and subscribed before me of Physical Presence or Online Notarization
this `day of sir A .8G _ 20?1 by
Name of person making statement.
Personally Known OR Produced Identification
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