HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE CONYC�TED FOR APPLICATION TO BE ACCEPTEiW� ✓J V �1 J
Date: �a1 a' Permit Number: / �d�' -2l 1
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Building Permit Application DEC 12 2017
Planning and Development Services
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 ft p a 1 r R)W
Address: W•
Legal Description:
Now inyroond VOU with pnr �K-
Additional work to be ertormed under this permit— check all apply:
HVAC 11 Gas Tank Gas Piping _ Shutters Q Windows/Doors
® Electric FX1 Plumbing Sprinklers 1-1 Generator Roof
Total Sq. Ft of Construction: -i �� `� Q' S ). Ft. of First Floor:
Cost of Construction: $ l� Utilities:n Sewer - Septic Building Height:
OWNER/LESSEE.
CONTRACTOR f " N E
Name STANDARD PACIFIC OF FLORIDA
Name: JOSEPH B. HOLSTON
Company: FOUNTAIN BLUE POOLS
Address: 825 CORAL RIDGE DRIVE
City: CORAL SPRINGS State: FL
Zip Code: 33411 Fax:
Phone No. 561-969-2299 Ext.407
Address: 2731 VIST PARKWAY SUITE D-1
City: WEST PALM BEACH State: FL
Zip Code: 33411 Fax:
Phone No. 561-969-2299 Ext. 407
E-Mail: construction@fountainbluepools.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: construction@fountainbluepools.com
State or County License: CPC 1458019
It value of construction is $2500 or more.,aRECORDED Notice of Commencement is required.
FEE SIMPLE TITLE HOLDER:
Name:
Address:
Citv:
Zip: Phone: _
Not Applicable
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
Not Applicable
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 nd posted on the jobsite
before the first in��ection. If you intend to obtain financing, consult with lender o an attorney before
commencing woyiflovikcording your Notice of Commencement.
s
_ Signatune"b5f Owner/ Lessee/Agent Signature of Contractor/Licens H der
STATE OF FLORIDA ��L� STATE OY FLORIDA
COUNTY OF TTLi COUNTY OF
The forgQyig instrument was acknowledged before me The forgoing instrument was acknowledged before me
this �y of �= 10 y this / day of 20 by
SSTEVEN DASSA-_,--- JOSEPH B. HOLSTON
(Name of p rson acknowledge g) ` (Name of per onacknow edge )
I .J.
(Signature of Notary Pub c tate a "//i�� (Signature of Notary 1�Jlic'Stat f p I owo/
Personally Known ORod• tibn Personally Known OR Pit�c�orf��
Type of Identification P duce �� a. Type of Identificatio Produced •�g`"�e�$xr '�
Commission No.
'oa= Commission No.
B t r Z gGG 124701
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Revised 07/ 15/2014 //1X. .SZ��;a���
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