HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED , O�Qb
Date: a/ Permit Number:
•
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 i- P,.7-lo
PROPOSED IMPROVEMENT LOCATION:
Address: 7273 S. INDIAN RIVER DRIVE
Legal Description: 7 36 41 S 150 FT OF S 11.75 AC OF N 24.75 AC OF FRACT SEC WITH RIP RIGHTS
(OR 3583-1588: 3732-1178)
Property Tax ID #: 3507-332-0003-000-6
Site Plan Name: POOUPATIO
Project Name: KING POOL
Setbacks Front Back:
II DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
CONSTRUCTION OF IN GROUND POOL WITH TRAVERTINE PATIO & FOOTER
Lot No.
Block No.
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit— check all apply:
❑HVAC LJ Gas Tank ❑Gas Piping _ Shutters ❑ Windows/Doors
❑ Electric ❑ Plumbing ❑ Sprinklers ❑ Generator ❑ Roof
Total Sq. Ft of Construction:J / Cost of Construction: $ �7
i 077 -
S Ft. of First Floor: _
Utilities:n Sewer ❑ Septic
Building Height:
i OWNER/LESSEE:
CONTRACTOR:
Name' 1 i,)-- Lw) ZGZ
Name: JOHN M. MAY
Address: 7273 S. INDIAN RIVER DRIVE
Company: JM CUSTOM POOLS INC
City. FORT PIERCE State: FL
Address: 2503 DYER ROAD
City: PORT ST. LUCIE ' State: FL
Zip Code: 34982 Fax:
Phone No.
Zip Code: 34952 Fax:
E-Mail:
Phone No. 772-240-3268
Fill in fee simple Title Holder on next page ( if different
E-Mail: jmcustompoolsinc@gmail.com
State or County License: CPC1458456
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of
is requirea.
a
�! SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applica
Name: M. RANDALL RODGERS
Address: 1801 HAZELWOOD DRIVE
City: FT. PIERCE
Zip:
Phone: 772-201-1634
State: FL
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: _
Address:
City:
Zip:
Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
Not Applicable
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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before #y first inspjaqion. If you intend to obtain financing, consult with lender or an attorney before
commending workbr 4ecording your Notice of Commencement.
STATE OF FLORIDA
COUNTY OF ST. LUCIE
The fo going inst���2ent��!as acknowledged before me
thisday of . 20 Q4 by
John knw,
(Nape of person acknowledging)
I`
of Florida )
Personally Knowp Y OR Produced Identification
Type of 'Identification -Produced
Commission
Revised 07/15/2014
�yr�otoeallotary Public State,ot
Kaylin J. May
0
Signip6re of Contract License older
STATE OF FLORIDA
COUNTY OF ST. LUCIE
The forgoing instrument was acknowledged before me
this3f2 day of M'4Xt-14 , 20_:" by
(Name of person acknowledging)
(Signature of N90y F utuB ic- State of Florida )
Personally Knowny OR Produced Identification
Type of Identification Produce
;;rr►u' WILLIAM H DONOVAN JR
No. COMmisdbPO GG093576
':�?ix•__..;; EXPIRES April 12, 2021
Notary Public State of Florida
William Henry Donovan Jr
aExpires
04/12/2025
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