HomeMy WebLinkAboutBuilding Permit Applicationi
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
i� ffcrIP_P�
�RL �s.
Permit Number: 70Cv- f69/
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
RECEIVE®
JUN .9 2017
PERM17 TIIVG
Commercial Resia er 6110tya FL
PERMIT APPLICATION FOR:
To Select from dropbox, click arrow at the end of line
Address: 11z,6V -I_d
Legal Descri
Property Tax ID #: / ' Lot No.
Site Plan Name: r r\J_s Block No.
Project Name:
Setbacks Front Back: �? F_ q0 Right Side: `7, G� Left Side:
INSTALLATION OF A POOL
FHVAC Gas Tank "Gas Piping
Electric 11 Plumbing ElSprinl
Total Sq. Ft of Construction.-B�
Cost of Construction: $ T-��0
Address:
City: /./�►':
Zip. -Code: .FID Fax:
Phone No-
E-Mail:
FL 0 19 H
Shutters ` 1_._.1 Windows/Doors
Generator Roof C�
S Ft. of First Floor: _
Utilities:CnSewer ®Septic
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Building Height:
Roof pitch
Name: BARRY MILLS
Company: CRYSTAL FOOLS OF INDIAN RIVER
Address: 4680 US1
City. VERO BEACH State: FL
Zip Code: 32967 Fax: 772-770-5961
Phone No. 772 W-3067
E-Mail: JIMMYRQCRYSTALPOOLSIRC.COM
State or County License: CPC1457120
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINIR _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE 1-101. :cat/� Not Applicable
Name: �jt/
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
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.
!ignature of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA��n-__
COUNTY OF �JZ/YYY
The tfday
ing instr ent was acknowledgey fore me
this of 20 D_IE,y
(Name of
Personally Known _
Type of Identification
Commission No.
Revised 07/15/2014
s
nature Contract /License Holder
i
STATE OF FLORID
COUNTY OF
The forgoing instrurpent was admowledge ore me
this 4A day of J� , 20 by
(Name of
State of Florida) (Signature
OR Produced Identification Personally
iced Type of Id�
ireAN, (gftly Public State of "Florida mmissio
. Frances Donza
�g A My Commission Gv 092440
State of Florida)
OR Produced Identification
Produced
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