HomeMy WebLinkAboutGreen Pool PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
`L�LUcL .
Planning and Development Services
Permit Number:
Building Permit Application
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Residential YES
PERMIT APPLICATION FOR: new In ground pool w/deck
PROPOSED IMPROVEMENT LOCATION:
Address: -7' 3 im E
Property Tax ID #: 3 q lq - 5-I - i� i n - C' Lot No. ( 0
Site Plan Name: -67 LL) CI-E 7n4 E-&)5 Block No.
Project Name: R- W 800 1-
DETAILED DESCRIPTION OF WORK:
G—p-curj I ebb L= IS w P
New Electrical Meter Second Electrical Meter_
I 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: (101, T
Sq. Ft. of First Floor:
Cost of Construction: Utilities: —Sewer —Septic Building Height.
OWNERAESSEE:
N
CONTRACTOR:
Name.WARREN SIGMAN
Address: _ Company:., .PRo QDbt_ C ZL ►7 5 L'Le-
City: State: ( Address: -+5Lv - > >G WAS
Zip Code:3t}C 01-9 Fax: City: STUART State: FL
Phone No. Zip Code: 34997 Fax:
E-Mail: t?eVkW-0 LV (-3& Phone N0772-237-7665
Fill in fee simple Title Holder on next page ( if different E-MailOFFICE@PROPPOLBUILDERS.NET
from the Owner listed above) State or County License CPC
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. 'a
(3
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ ENGINEER:
Name: MARKHAM SERVICES INC (57216)
Address: 1820 NE JENSEN BEACH BLVD #685
CitV: JENSEN BEACH
_Not Applicable MORTGAGE COMPANY:
Name:
Zip: 34957 Phone 954-941-1124
State: FL
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:
Address:
City:
Zip: Phone: -
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone: -
x Not Applicable
State:
x 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 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 rec9i0ft au r Notice of Commencement,
Signature of Ow V
Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF 6-r Lu Laic
Sworn to (or affirmed) and subscribed before me of
-"'P'hysical Presence or Online Notarization
this �3 day of�- 2021 by
ntractor/License Holder
STATE OF FLORIDA
COUNTY OF 1,0
Sworn to (or affirmed) and subscribed before me of
'Physical Presence or Online Notarization
this _►_ day of b e 2029 by
2 -S- -k) G-rZ
Name of person making statement. Name of person making statement.
Personally Known
OR Produced Identification
Type of Identification
Produced [
S
(Signature of
Commission N`^
r!?iPJJJ0
M1
Notary Public State of Florida
i{er A Sisson `Sealommisslon GG 950 11
Spires 0112212024
Personally Known ✓ OR Produced Identification
Type of Identification
Produced
• '; 55r]^--�
(Signature of Notary uhlic- State of Florida )
Com
Notary Public Stale of FIMIR 1)
meson
f My Commission GG 950211
REVIEWS I FRONT i
ZONING SUPERVISOR I PLANS I VEGETATION SEATLTRTLE MANGROVE
I COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE I
RECEIVED
DATE
COMPLETED
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