HomeMy WebLinkAboutBuilding Permit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
:1
ti Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential YES
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: new in ground pool w/deCk
PROPOSED IMPROVEMENT LOCATION:
Address q (Q a a- -5T-mrprio b2SA/E
Property Tax lD # o"1y3(p
Site Plan Name:
Project Name: N4A,.-) f oai--
DETAILED DESCRIPTION OF WORK:
Q b In= 6-YU On n 12 o o kL-
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
Lot No. a
Block No. AZIA
Mechanical Gas Tank _ Gas Piping _ Shutters Windows/Doors
electric ✓Plumbing —Sprinklers —Generator —Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 57j. 54 60 Utilities: —Sewer —Septic Building Height:
FWNER/LESSEE: I CONTRACTOR:
Name El2f)
Address: dS 5 _L.yd A•� I�,,;t2 Da'.
City: /=oar AL-ilaez State:
Zip Code: ,3L/S S,R Fax:
Phone No. 77a — 77:3 _'�$
E-Mail: 0v661'cs41000 /0 kwAo❑- cGJ-
-mil_
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name:WARREN SIGMAN
Pond
Pitch
Company:.p(ZO Vabi_ Bus LD S LL.C__
Address: �b W F-Sit w R
City: STUART State: FL
Zip Code: 34997 Fax:
Phone No772-237-7665
E-Mail OFFICE@PROPPOLBUILDERS.NET
State or County License CPC 14 Sq('q�
L I --
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:
Name: MARKHAM SERVICES INC (57216)
Address: 1820 NE JENSEN BEACH BLVD #685
CItV: JENSEN BEACH
Zip: 34957 Phone 954-941-1124
Not Applicable
State: FL
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
Citv:
Zip: Phone:_
x Not Applicable
State:
BONDING COMPANY: x 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 nta representation that is granting a permit will authorize the permit holder to build the subject structure
which is in contlict 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 recording your Notice of Commencement.
Signature ❑ wner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OFL_L2eCE
5 orn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this _QL day of 2021 by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced A L
(Signature of Notar Public- tate of Florida
r • NK �yub1{n State aF Florida
Commission No. � Sisson
K My Cammisslon GG 950211
%,;,,,dP Expires 0112212024
re of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF_ a,
Sworn to (or affirmed) and subscribed before me of
X Physical Presence or Online Notarization
this I day of Ai pit6m&e-i° 2029 by
-9. W A-0_"
Name of person making statement.
Personally Known Y
Type of Identification
Produced
OR Produced Identification
gnature of Notary Pub - t
mmission No.
Notary p�_bl'icI tate of Florida
Kerry n
s My Commission GG 950211
Expires 01122f2024
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DATE
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DATE
COMPLETED —