HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
.� Date: _ Permit Number: X
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Building Permit Application JUL P. 7 2017
Planning and Development Services
Building and code Regulation Division PEREOTTfNG
2300 Virginia Avenue, Fort Pierce Ft 34982 St. Lucie County, i=f-
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line o L
PROPOSED IMPROVEMENT LOCATION:
Address: �_t (� tau% rtJ,��, Legal Description: f� S �•��P (�2..�T 1 15ck 2 /-b_r
Property Tax ID ##: tI ?,0 / Vo * bVo —
Lot No.
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
INSTALLATION OF A POOL r SPA-
PA -
CONSTRUCTION INFORMATION: -
Additional work to beele
orme un er t is permit—c ec a app y:
EjHVAC LGas Tank ®Gas Piping _ Shutters
11 Electric 0 Plumbing Sprinklers 0 Generator
Total Sq. Ft of Construction:
Cost of Construction: $����
S Ft. of First Floor: _
Utilities:T]Sewer OSeptic
OWNER/LESSEE:
Name A:L I DTb
Address: 'Ll Q, 9 OL iW wt�-�
City: eA'La, State:
Zip Code: `T Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
Name: BARRY MILLS
Block No.
QWindows/Doors
Roof C� Roof pitch
Building Height:
Company: CRYSTAL POOLS OF INDIAN RIVER
Address: 4680 US1
City: VERO BEACH State: FL
Zip Code: 32967 Fax: 772-770-5961
Phone No. 772-567-3067
E-Mail: JIMMYR@CRYSTALPOOLSIRC.COM
State or County License: CPC1457120
If value of construction is 22500 or more, a RECORDED Notice of Commencement is required.
-SUPPLEMENTAL`CONSTRUCTiON LIEN LAW INFORMATION:
INEER: Not
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE BOLDER:
Name:
Address:
City:
Lip= Phone:
Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Lity: State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City: _
LIP: - Phone:
Not Applicable
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_
Xignure of weer/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
thrs'21- day of �t 20 /�__by
Name
/i•/V
Notary Public-8fate of Florida 1
Personally Known �/_ OR Produced Identification
Type of Identification Produced
Commission No.
3,�
Revised 07/ 15/2 114 ,
REVIEWS FRONT
COUNTER
DATE
COMPLETE
INITIALS
AMES ROUAN
MY COMMISSION # GG 008627
Bonded Thru Notary Public Underwriters
Signature of ontractor/�cense Holder
STATE OF FLORIDA
COUNTY OF_<j G vl
The forgoing instrument was acknowledged before me
this 2Yday of �f�rt� 20 a by
(Name of person
(Signature of
Personally Knob ✓ OR Produced Identification
Type of identification Produced
Commission No.
ZONING SUPERVISOR PLANS
REVIEW REVIEW REVIEW
JAMESROUAN
MY COMMISSION # GG 008627
Bonded Thru Notary Public Underwriters
VEGETATION I SEA TURTLE I MANGROVE
REVIEW REVIEW REVIEW
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