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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3—a? �/ A,,)� Permit Number:
RECEIVED
Building Permit Application MAR 2 5 2022
Planning and Development Services St. Lucia Courity
Building and Code Regulation Division ��rlltirt�
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: 5458 SILVER OAK DRIVE
Legal Description: INDIAN RIVER ESTATES UNIT 06 BLK 23 LOT 8 AND N 33 FT OF LOT 9 (MAP 34/11 N)
Property Tax ID #: 3402-607-0277-000-8
Site Plan Name: WESTCOTT
Project Name: POOL
Setbacks Front Back:
Right Side: Left Side:
I'DETAILED DESCRIPTIONI OPWORK:
CONSTRUCTION OF IN GROUND POOL AND PATIO
56 11Pr'rxi �vtrLaSu2C 73%r 0 7W e /k, S
Lot No.8
Block No. 23
CONSTRUCTION INFORMATION:
Additional work to E]GasTank
ee orme un er t is permit —c ec a app y:
F]HVAC Gas Piping _ Shutters a Windows/Doors
11 Electric 0 Plumbing Sprinklers O Generator Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ cs UtilitiesSewer Septic Building Height:
J OWNERAESSEf:..°
CONTRACTOR:
NameDAVID/SARAN WESTCOTT
Name: JOHN M. MAY
Company: JM CUSTOM POOLS INC
Address: 2301 ,NE SAVANNAH RD. UNIT 1682
City: JENSEN BEACH State: FL
Address: 2503 DYER ROAD
Zip Code: 34958 Fax:
City: PORT ST. LUCIE State: FL
Phone No.
Zip Code: 34952 Fax:
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
it value of construction is $Z500 or more, a RECORDED Notice of Commencement is required.
SUJ? LExMENTAL GONSTRUCTION,LIEN LAW INFORMATIOI N:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: ^ Not Applicable
Name: M. RANDALL RODGERS
Name:
Address: 1801 HAZELWOOD DRIVE
Address:
City: FT. PIERCE State: FL
City: State:
Zip: Phone: 772-201-1634
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ 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 vour Notice of Commencement.
Sig re o n Agent/ Lessee
STATE OF LORIDA
COUNTY OF ST. LUCIE
The fo g instru nt was a Icnowledged before me
this 01ay of 20&3—L by
!r Wt*'0#--
(Narqe of person acknowledging )
- Ku lilij.
Personally Known OR Produced Identification
Type of Identification Produ
�i yr fe Notary Public State of Florida
Commission N665b I �P �9 �I . May
y o mission GG 90081
I R/ Expires 10/0312023
Revised 07/15/2014
519A, at,ure o •ontrac o / ' ense Ho er
STATE OF FLORIDA
COUNTY OF ST. LUCIE
The f r ing instrument was acknowledged before me
thisoday of fK t4 P_ 414 .20 by
(Name of person
(Signature of ary Public- State oMorida )
Personally Known&/11�011 Produced Identification
Fype of Identification Produced
.►W Pa. Notary Public State of Florida
_ J _ William Henry Donovan Jr
Expires 04/12/2025
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