HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi
ALL APPLICABLE INFO pMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED11
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Date: (0.2 • I tl SC BY Permit Number: l (1 O0 _ (XQLZ�
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St. Lucie County
RECEIVED
Building Permit Application JUN 2 5 2018
Planning and Development Services ST. Lucie Cgunty, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)� 462-1553 Fax: (772) 462-1578 Commercial Residential X
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PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line1.
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description: PODS 12 AND 13
I
1 AT THE RESERVE SCARBROUGH ESTATES (PB45-13) LOT 19 (OR 4127-1401
Property Tax ID #: 3322-507-0024-000-8
Site Plan Narrje: l C �o lie
Project Name'
S o_r f
Setbacks F1117
lront Back:Z�sDaght Sider Side:
Lot No. 19
Block No. 12 & 13
I. DETAILED DESCRIPTION OF WORK:71
II
INSTALL SWIMMNG POOL AND SPA WITH TRAVERTINE PAVER DECK WITH SCREEN
CONSTRUCTION INFORMATION:
Additional vyor to be nertormed under this permit— check all apply:
❑HVAC1, EjGasTank ❑Gas Piping rn Shutters ❑ Windows/Doors
RElectr c EN Plumbing ❑Sprinklers ❑ Generator ElRoof Roof pitch
Pool l S I
Total Sq. Ft of Construction:0 s _ i � & S Ft. of First Floor:
Cost of Construction: $ 0 8 0 Utilities. Sewer ❑ Septic
Building Height:
OWNER/ ESSEE'
CONTRACTOR:
Name A' Lcke.r'Fe Lot R or1+
Name: 1 r \I w >>C
Address:- W �-\AY1oc)o J SU w D,( Q(-V
Company:UolG to CDY'e^
Address: q,' % to S , �=t fir,
1 ���►.) \/
City: lri�,Jr P� LY C R_ State: FL
Zip Code: Fax:
City: ` ni-N- e..
State, L
Phone No. i.'a1 � �3 �' (ja <6 -!I o
Zip Code: � °I S a Fax:
E-Mail:
Phone N a3`}
Fill in fee simple Title Holder on next page ( if different
E-Mail:
from the Owner listed above)
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State or County License: L
3
If value of construction is $2500 or more, a R CORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION.
DESIGNER/ENGINEER: _
Not Applicable
Name:Gc 'o,s r' aS
Address: ` 1 Fh
Norfih
City: O e S Zlfect
State: FL.
Zip:'3' �11!\ Phone
6SL)
FEE SIMPLE TITLE HOLDER:
Not Applicable
Name:
Address:
City:
Zip: I Phone:
MORTGAGE COMPANY: /�Sl_ Not Applicable
Name: '
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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 lof 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 bu'i,lding 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 iOWNER: 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.
re of Owner/ Les_p67Contf�or as Agent for Owner
STATE OF FLORIDA
COUNTY OF STLUCIE
I
The forgoing instrument was acknowledged before me
this 31 day 4 MAY , 20_ by
ROBERT S ASCHERFELD
Name,of person making statement
Personally Known OR Produced Identification x
Type of Identification
Produced
ignature of Notary Public- State of Florida )
`1PwY'¢ym., JO FiWILLS
Commission No: ((
iss
mon # FF 188304
A qe� B xpiresnded �February 20, o019 7019
REVIEWS 'I NING
COUONTER NT I REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
Signature of Cont ac or/License HcVder Vc i .(� "to
STATE OF FLORID(► I
COUNTY 0. - tI W6 C
The forgoing instrument was acknowledged before me
this ALday of SuvN_e 20JI by
Name df person making statement
Personally Known X OR Produced Identification
Type of Identification
Produced
�Notary Public State of Florida
Commis o AThomasina Bowins
201733
e.w EVires03MOV2022
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