HomeMy WebLinkAboutBUILDING PERMIT APPALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Planning and Dew
Building and Code
2300 Virginia Aver
Phone: (772) 46i
Building Permit Application
vent Services
elation Division
Fort Pierce FL 34982
53 fax: (772) 462-1578
Commercial Residential X
PERMIT APPLICATION FOR: Pool inground ---�
Address: IUIQ'
Legal Description:
Property Tax ID #:
Site Plan Name:
Project Name:
Setbacks Front
Installation of G
Total Sq. Ft of
Cost of Constr
Address --A
City:
Zip Code:
Phone No.
Pill in fee simple
from the Owner
Back: Right Side: Left Side:
Pool, Deck and Equipment
..+ - sw u,cv u„ucl �lliD (rcl 11 I11. -' i.l
Gas Tank ❑Gas Piping
(� �✓_ Plumbing, Sprinklers
Lot No.
Block No.
Shutters Windows/Doors
Generator O Roof
J on: t � . I A)V J S-Ft. of First Floor:
s-D -� Utilities: lJSewer Septic Building Height:
i I
Name: TerrY vvlx
Company: Pools by Greg, Inc.
�s
Q State:
Z_ Fax:
Address: 8886 S Federal Hwy
Gty: Port St Lucie State: FL
Zip Code: 34952 Fax: 772-337-9287
Phone No. 772-337-9713 -
E-mail. office@poolsbygreginc_com
Hoider on next page ( if different
I above)
State or County License: CPCI458838
if value of constructio f is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: — Not Applicable
Name: M. RANDALL ROGERS
Address:1B01 HAZELWOOD DRIVE
City: FORT PIERCE State: FL
Zip: 34982 Phone772-201-1634
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City. -
Zip: Phone:
IFORMATlON:
BONDING COMPANY:
Name:_
Address:
City:_
Zip: Phone:
_Not Applicable
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 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 your Notice of Commencement.
Signature of Qwnr r/ Lessee%Contractor as Agent for Owner
STATE OF FLOR D
COUNTY OF
The fgrfoing instrument was acknowledged before me
this ''l day of_ D-ef 20Z by
TERRY WIX
Name of person making statement.
Personally Known_ OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida )
Commission No.
(Seal)
REVIEWS
FRONT
ZONING SUPERVISOR
COUNTER
REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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otary Public State fFlorida
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My Commission GG 201733 w.
Expires 03/2912022
OF A
Signature of Co, ctor/Licel:ise Holder
STATE OF FLORIDA
COUNTY OF 5t
The for oing instrument �was acknowledged before me
this day of f 20� by
TERRY WIX
Name of person making statement.
Personally Known \�c_ OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida } `
Commission No. (Seal)
PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW
A Thofi •` 1' nuno
asina Bowins
i My Commission GG 201733
Expires 03/29/2022