HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLI ABLE 1 FO MUST
BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �� � C� SCANNED Per -Number:
`' � al��-1 15
BY
Building Permit Application WZ L ®��d
Planning land Development Services
Building ci�nd Code Regulation Division
2300 Virg) nio Avenue, Fort Pierce FL 3498 Y x
Phone.( 72) 462-1553 Fax: (772) 62-1578 Commercial R s
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PRO'PO ED IMPROU ENT LOCATION
Address: Ib75 Johnston Rd, Ft Pierce FL 34951
Legal Desc iption: 27.34.39N 1/2 of SE 1/4 of NW 1/4 of SE 1/4 -Less E 65 ft
Property ID #: 1327-424-0001-000-6
Site Plan P(lame: Long
Project Nae: Long eN
Setbacks Front "Ri k: A
Right Side: g"" �) Left Side:�
Lot No._
Block No.
DETAILI"D"DESCRIPTI.ON OF WORK•
.77
Inground Swimming Pool with Deck
CONSTf UCTION INFORMATION:
Add ition I work to e e orme under this permit— check a apply:
�HV C El Gas Tank ❑Gas Piping Shutters ❑ Windows/boors
i
Elet tric 0 Plumbing Sprinklers nGenerator Roof Roof pitch
Total Sq. t of Construction: S . Ft. of First Floor:
IIi
Cost of Cq struction: $ 37,812.00 Utilities: _ Sewer E]Septic Building Height:
II
OWNE/LESSEE
_<
-CONTRACTOR:
Name 13 an or Aimee Long
Name: Wade M Clarke
Address: ,,`075Johnston Rd
Company: Horizon Pools Inc
City: Ft P fierce State:FL
Address: 5423 Stately Oaks St
Zip Code 34951 Fax:
City. Ft Pierce State: FL
Phone N 772-466-3303
Zip Code: 34981 Fax:
E-Mail:
Fill in fee
from the
I
Phone No. 772-801-8510
E-Mail: horizonpools.sandy@gmail.com
State or County License: CPC1458644
simple Title Holder on next page (if different
iI wrier listed above)
------------- -- - -
,a q&..7YY ul 11HJFC, Cl nc-unucu ivotice or commencement is required.
SUPPLE;
ENTAL C.ONSTRUC 1 K LIEN
LAW INFORMATION
DESIGN
Name: Gre
Address:
City: west
Zip:
I/ENGINEER: _ Not Applicable
oryArias
MORTGAGE COMPANY: vNot Applicable
Name:
Address:
City: State:
Zip: Phone:
2115 56th Place,N
dim Bean State: FL
I Phone3o"79-0541
FEE SIMF
Name:
Address:
city:
Zip:
LE TITLE HOLDER: Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Address:
II
III
City:
III Phone:
Zip: Phone -
OWNER/ I IONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify tha no work or installation has commenced prior to the issuance of a permit.
i
St. Lucie Co ptyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in c ntlict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. PI Vase 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 accordan a 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 st uctures, 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'firs inspection. If you intend to obtain financing, consult with lender or an attorney before
commenci ork or recording your Notice of Commencement_
Signature
wner/ Lessee/ C Agent for Owner
actor as
Signature of Contractor License Holder
STATE OF
COUNTY
FLORIDA
wi i
STATE OF FLORIDA I
F ✓>` i°
COUNTY OF
The forgoi
this � d''
'g instrument w s acknowledged before me
y of =i 20� by
The forgoing instrum�n was acknowledged before me
this day of Ji 20 ? by
N
Personally
me of person king statement /
(nown OR Produced Identification d
Name of perso making statement
Personally Known
OR Produced Identification
Type of Id
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Type of Identification
Produced
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(Si ature of Notary Public ate of Florida )
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REV
REVIEW REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17