HomeMy WebLinkAboutBuilding Permit AffidavitALL APPLICAB INr �M]US BE COMPLETED FOR APPLICATION TO BE ACCEPTED I
Date: - ` - l I7
Permit Number:
NOV 0 7 2017 1
Building Permit Application
Planning and Development Services
BY.
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772).462-1578 Commercial Residential
PERMIT APPLICATION FOR: pool inground
PROPOSED IMPROVEMENT LOCATION:
Address: 725 W COKER ROAD, FORT PIERCE
Legal Description: - 08 35 39 N 420.54 FT OF W 517.95 FT OF E 562.45 FT OF S 1/2 OF S 1/2 OF SE 1/4
Property Tax ID #: 2308-444-0001-000-2 Lot No.
Site Plan Name: Block No'.
Project Name: BRANSCOMB
Setbacks Front �-3S Back: Right Side: Left Side: 10S
.DETAILED DESCRIPTION OF WORK: -
INSTALL GUNITE SWIMMING POOL WITH CONCRETE DECK
CONSTRUCTION INFORMATION:
Add Itlona I -work to e e orme - under this permit.— c ec a app y:
�HVAC E] Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total.Sq. Ft of Construction: S . Ft. of First Floor:
J�-
Cost of Construction:.$ 000 • Utilities: 0 Sewer E]Septic Building Height:
OWNER/LESSEE:
CONTRACTOR: .
Name 1"Q.i'2
Name: James T. Leonard
Address:1010 Nu V W
Company: A & G Concrete Pools, Inc.
City: F+ 'Pl ac-0- State: f7L
Zip Code: �f5 Fax:
Address: 410 Saeger Avenue
ity: Fort Pierce State: FL
Phone No. '"
ip Code: 34982 Fax: 772-467-1624 -
hone No. 772-878-7752
,.l
E-MaiI:.S 1 VIA' o
Fill in fee simple Title Holder on next page (if different -
E-Mail: FHERNANDEZ ANGPOOLS.COM
from the Owner listed above)
State or County License: CPC1457902
If value of construction is 52500 or more, a RECORDED Notice of Commencement is required'
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNERANGINEER: _ Not Applicable..:' MORTGAGE COMPANY:. Not Applicable
Name: Ray Reinhard Name:
Address: 1o10 Easter Lilly Lane Address:
City:. Vero Beach. State: FL City: State:
Zip: 32963 Phone:..(772)473-6303 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 hascommenced 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 withany 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,
accessorystructures, 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.yot r.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. "
re
as Agent for Owner
�J s
STATE OF FLORIDA
COUNTY OF 6+•�
The forgoing instru as acknowledge efore me
this nt 'day of 20 �_by
(Nargie�of pey oo,i acknogledging) .
Contractor/LiceVe Holder
STATE OF FLORIDA
COUNTY OF St. Lucie
The rday
ing instru nt was acknowledge fore me
this of 20 by
(Na
T. Leonard
( ignature of NotaN Public -State of Flo a) / lignature of Notary Public- State of Florl )
Personally.Known OR Produc. d Ide it
Y Personally Known OR Produce Iden 'fication'.
Type of Identification Produced Type.of Identification Produced
°o : FARA [� RNANDEZ ,.._�
Commission No., o; Commission. No. .
MY COMM►Ss ON #FF1724is 3a '°�;� FARAD HERNANDEZ
1- EXPIRES October 28, 2018
Ievised 07/ 1
53
398-0153
EXPIRES -October 28, 2018
\WS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE'
REVIEW_