HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5/23/18 ESPermit Number:
I �oS� D�zf
StLudeCook
Building Permit Application 14Ay'23201
Planning and Development Services P=m7ittip9 D B
Building and Code Regulation Division St. Lucie �tlah rnenr
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: /L1Y) arovlle, Ave / v✓� �0 ��rGN �C.
Legal Description- 9 35 39 E 163.67 FT OF W 1/2 OF NW 1/4-LESS R/W FO � ORANGE AV ASIN PB 22-16 AND LESS W 143.67 Fr OF S 280 FT- (9.24 AC) (OR 4097-2549)
Property Tax ID #: 2309-223-0001-000-6 Lot No.
Site Plan Name: Hall Pool Block No.
Project Name: I
Setbacks Front�2L� Back: Right Sider Left Side:
i
DETAILED DESCRIPTION OF WORK:
Build inground gunite pool with paver deck I
vbol 3v
I
CONSTRUCTION INFORMATION:'
Adclitional work to e e orme under this permit- check a a apply:
0HVAC 11 Gas Tank []Gas Piping , Shutters ❑ Windows/Doors
✓Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
,'Total Sq. Ft of Construction: 1394 Sq. Ftl, of First Floor:
Cost of Construction: $ 53,200 Utilities: ISewer 0Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name K0144
Name:,, �5—arw 0 D/✓j
Address: //%/0 L?rA I� r
Company: Odom Custom Pools
City: )51f- T &Y, State: FL
Address1, 1056 Old Dixie Hwy
Zip Code: 34945 Fax:
City: - Vera )7r;01&h State: FL
Phone No. 7724739692
Zip Code:132960 Fax:
E-Mail:
Phone No772-473-9692 --
Fill in fee simple Title Holder on next page (if different
E-Mail: jodpm@odomcustompools.com
from the Owner listed above)
State or Co�nty License: CPC1458195
- c -at. WIL W., .a qa L7 N..Ilu!C, d ncLunlicu Ivouce or l.Ommencemenr is regwrea.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
{
DESIGNER/ENGINEER: _ Not Applicable
Name: Ari%
MORTGAGE COMPANY: _ Not Applicable
_&few-g S
Name:
Address: !
Address:
City: State: I
City: State:
Zip: Phone I
I
Zip: Phone:
FEE SIMPLE TITLE HOLDER: — Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address: 1056 Old Dixie Hwy I
Address:
City: I
City:
Zip: Phone: I
I
Zip: Phone:
uMNICK/ LUIV 1 KA11.I UK 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 grantingla 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, lscreen 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 vnur Nntirp of rnmmanromcnt
Signat of Owner/ Lessee/Contractor as Agent for Owner
Signature ntractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF 64- L, (26cl
COUNTY OF St- LvGire (ou/L/L
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this s2J-day of /yl oLV 20 I V by
this ga day of Aa V 20 by
Name of per making statement
Name of person making statement
Personally Known t/ OR Produced Identification
Personally Known !/ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signatur
(Signature Nor,public- SIR '
M. MILLER•I��Notary
Commissic(J4al
I
]a)ROBERTA
Public - State of FloNotaryPublic-StateofFl�
Commission 9GG 122539
COmmIS510 ]�
GG 122530omm.
My Comm. Expires Jul9,2021
-.�oF `'piresJul9,24,zUrov-
rough NationalNotary
Bcnded throuch Netional NotaryAssr. I
REVIEWS
FRONT
ZONING
SUPERVISORI
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
�Ip`
I,
RECEIVED
d
DATE
COMPLETED
Rev. 8/2/17