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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONr ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: !) q . I� Permit Number: Vn RECEIVE® Building Permit Application AUG 2 8.20V Planning and Development Services Building and Code Regulation Division PERMITTING 2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie County, FL 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 .PROPOSED IMPROVEMENT LOCATION: Address: 11700 APPALOOSA CT, PORT ST LUCIE FL 34987 Legal Description: PONY PINES -UNIT ONE, BLOCK A, LOT 15 Property Tax -ID #: 3309-605-0018-000-3 Site Plan Name: Project Name: SIGEL Setbacks Front � Back: I LO Right Side DETAILED DESCRIPTION OF WORK: . INGROUND SWIMMING POOL WITH DECK Left Side: Lot No.15 Block No. A CONSTRUCTION INFORMATION: Additional work o e nefformed under this permit —check all t= apply: [3HVAC Gas Tank ❑Gas Piping _ Shutters ❑ Windows/Doors 11 Electric 0 Plumbing Sprinklers Generator O Roof Roof pitch Total Sq. Ft of Construction: S Ft. of First Floor: Cost of Construction: $ 33,844.00 Utilities:0Sewer OSeptic Building Height: OWNER/LESSEE: CONTRACTOR: NameJUSTINE SIGEL Name: WADE M CLARKE Address:11691 APPALOOSA CT Company: HORIZON POOLS INC City: PORT ST LUCIE State: FL Address: 5423 STATELY OAKS ST Zip Code: 34987 Fax: City: FT PIERCE State: FL Phone No.772-332-0700 Zip Code: 34981 Fax: E-Maii:justinesigel@yahoo.com Phone No. 772-801-8510 Fill in fee simple Title Holder on next page ( if different E-Mail: horizonpools@att.net from the Owner"listed above) State or County License: CPC1458644 If value of construction is.52500 or more, a RtcuRutu notice oT Lommencemenr is regwrea. SCM0 EndoSore- l`7o�" 6 �9O 5UPPL_EMENTAL.CONSTRUCTION LIEN LAW INFORMATION. DESIGNER/ENGINEER: Not Applicable MQRTGA§g GgMPANY: — AI?P.,4cble N a m e: GREGORy ARIAS Name: NIA Address: Address:12115 56TH PLACE, N City: WEST PALM BECH State: F- City: State: Zip:33411 Phone30,5-87M541 Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable I BONDING COMPANY: Not Applicable Name: N/A Name: N/A Address: Address: City: City: Zip: Phone: Zip: Phone: _ OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. 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 commencine work or recording vour Notice of Commencement. Signa of Owner/ Lessee/Co'ntractd as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF---- COUNTY OF! ---- The forgoing instrum nt was acknowledged before me this day of &7 20 Eby The forgoing instrurVpnt was acknowledged before me this day of 20� by Name of person aki statement ... .-.� Personaiiy Known ✓✓✓ urc Produced identification Type of Identification Name of person making statement I1. �ORr--_J_____I I_I C_ rersur�a��y kiiuv�i� vrt rrCuu�ru wei�iiu�aiiuii Type of Identification Produced Produced (Ginn IIIru of Nntmni D.iklir- St�t� f ,_.b. NOTARY P U I1 Commission N OFF���8R (9 ura of Nntnry Piihlir- Stay Florida 1 - -- - - 40sandra A Commission No Y�E�aI) Ceram# U0p325W N sI° Expires 3/0/2020 STATE PP FLORIDA WC=Q* 6GO32556 E 'res 3/02020 REVIEWS FRONT ZONING SUPERVISOR COUNTER REVIEW REVIEW PLANS VEGETATION I SEA TURTLE • MANGROVE REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17