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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/20/21 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
PROPOSED IMPROVEMENT LOCATION:
Address: 18602 MACH ONE DRIVE
Legal Description: AERO ACRES BLK 1 LOT 6 (2.065 AC) (OR 638-1367)
Property Tax ID #: 3215-801-0013-000-2
Site Plan Name: HELSETH
Project Name: POOL
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION OF IN GROUND POOL AND PATIO
Lot No.6
Block No. 1
CONSTRUCTION INFORMATION:
Additional work to b
orme under t—checkispermit a apply:
E1HVAC fl Gas Tank ❑Gas Piping _ Shutters a Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: _
Cost of Construction: $ 58,000
S Ft. of First Floor: _
Utilities:] Sewer ElSeptic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameCRAIG/DIANE HELSETH
Name: JOHN M. MAY
Address: 18602 MACH ONE DRIVE
Company: JM CUSTOM POOLS INC
City: FORT PIERCE State: FL
Address: 2503 DYER ROAD
City: PORT ST. LUCIE State: FL
Zip Code: 34987 Fax:
Phone No.
Zip Code: 34952 Fax: N/A
E-Mail:
Phone No. 772-240-3268
Fill in fee simple Title Holder on next page (if different
E-Mail: jmcustompoolsinc@gmail.com
from the Owner listed above)
State or County License: CPC1458456
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name: M. RANDALL RODGERS
Name:
Address: 1801 HAZELWOOD DRIVE
Address:
City: FT. PIERCE State: FL
Zip: Phone: 772-201-1634
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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.
STATE OF FLORIDA
COUNTY OF ST. LUCIE
The forgoing instr}ne �t as acknowledged before me
this - day of U �J�� 20�_=' by
Ova)' H-(?.,(,s-Oh
(Narap of son acknowledging)
i
7lic-
zk4��K
Sig ture of ContractLicens Holder
STATE OF FLORIDA
COUNTY OF ST. LUCIE
The for oing instrument was acknowledged before me
this day of 3 jF" tt R £je , 2021 by
,2 o rfR% iNL , M A)(
(Name of person acknowledging) _.,
(Signature of Not r�Wubli�- State
Personally Known -1 OR Produced Identification Personally Known tiv OR Produced Identification
Type of Identification Produced Type o entification Produced
Commission No.1711�Co ���r al)
�r ru Notary Pubtio state of Flori rrrrr Not�rY Shte d Florida
c' f Kaym J._Wy r_r. w6 l %I"' tKlliam Henry Donovan Jr
.,
1,01031202
Revised 07/15/2014
Expires o4n2/2025
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