HomeMy WebLinkAboutPERMIT APPALL APPLICABLE INI(O MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
_0 Building Permit Application
Planning and Develo meat Services
Building and Code R gulation Division
2300 Virginia AvenuE, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION
FOR: Pool inground
it R
Address:
Legal Description:
i
Ct5
Property Tax ID#*_A_)LAQ
- i0bo - 0)(DU 000- -Lot No.
Site Plan Name: A
rh f�s t I' 12SLt Block No. 1b
Project Name:
F
Setbacks Front
Back: Right Side: Left Side:
ifte Pool, Deck and Equipment
Installation of Gu
y
Iona war o i nerformea una e_r"�isPerm"c
eca apY_
1HVAC Gas Tank EGaspiPinP _Shutters rs Widwsl Doors
ZJ
Electfic 0 Plumbing Sprinklers Generator Roof
El
Lis
Total Sq. Ft of Construction:�C' V_- -7ciq Sq- Ft- of First Floor:
Cost of Construction Utilities: 0 Sewer Septic Building Height:
er g�- i
W-1 ' M
101 1
Nam.= I Name: Terry Wix
Address:. OR �!A Company. Pools by Greg, Inc.
City: 1 Uko State: Address: 8886 3 Federal Hwy
Zip Code: City: Port St Lucie State: FL
Phone No. Zip Code; 34952 Fax: 772-337-9287
E-Mail: Phone N,. 772--337-971:3
Fill in fee simple rdt 9 Holder on next page (if different F-Mail: officeopoolsbygreginc-com
from the Owner list d above) State or County License: CPC1458338
Ifvalue ofconstructio
ct.
_5()o or,
is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER:
Name: M. RANDALL ROGERS
Address; 1ao1 FIAZELWOOD DRIVE
City: FORT PIERCE
Not Applica
State: FL
WIN FORMATION:'
Zip: 34982 Phonen2-2o1-1a34 —
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
State:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
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 is in conflict with any applicable Home Owners Association rules, bylaws or and structure. Please consult with your Home Owners Association and review your deed focovenants that may restrict or prohibit such
r any restrictions which may apply.
In consideration of the granting of this requested permit, 1 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 CommencPmtnnt
Signature of Q r/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this day of 20_ 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 .►Ar NQN_ Diary Public State f Florida
a My Commission GG 201733
��IJF Expires 03/2912022
Signature of Co ; ctor/Lic 'se Holder
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this day of 20_ 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)
PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW
A Thomasina
8owins
i My Commission GG 201733
Expires 03/29/Z022