HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO TMPOLETED FOR APPLICATION TO BE ACCEPTED
Date:' �JC / SCANNED Permit Numb
By
. St. Lucie County
H Building Permit Application
Bob 0 0 aa
AUG 2 4 2018
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue, Fort Pierce FL 34982 t. i_ i e County, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPIPSED IMPROVEMENT LOCATION
Address: 1801 Hazelwood Dr, Ft Pierce FL 34982
Legal 0 scription: ESTATES OF LONGWOOD, lot 24
t
PropertlIy Tax ID #: 2433-502-0024-000-1 Lot No.24
Site Plz'h Name: Rodgers Block No.
Project Name:
Setba ii s Front Back: 7. Right Side: Left Side:
DETAILED DESCRIPTION OF',WORK.
Ingrou d gunite swimming pool with concrete deck
CqN, TRUCTION -INFORMATION.;
ACIditional worK to be erformed under this permit — cheCK all apply:
®IHVAC Gas Tank Gas Piping Shutters Windows/Doors
_� 0 p
ElElectric 0 Plumbing []Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: SIn
of First Floor:
Cost o Construction:.$.49,415.00 UtilitiesSewer F]Septic Building Height:
O„W.
ER/LESSEE`:, ... ,.
,CONTRACTOR:
Name
Marvin R or Tiffany. 1 _Rodgers
Name: Wade M Clarke
:1801 Hazelwood Dr
Addre
City: Ft
company: Horizon Pools Inc
Address: 5423 Stately Oaks St
Pierce State: FL
Zip Code:
PhoneNo.772-201-1634
E-Mai
34982 Fax:
City: Ft Pierce State: FL
Zip Code: 34981 Fax:
Phone No. 772-801-8510
kxfox@hotmail.com
-e Simple Title Hdlder an tiekt page ( if different
Ne Owner listed above)
E-Mail: horizonpools.sandy@gmail.eom
State or County License: CPC1458644
Fill ifi f
from t
If value, Hof construction is $2500 or more, a RECORDED Notice of Commencement is required.
AN
SUP
rLEMENTAL CONSTRU„CTION LIEN L�AVU INFORMATION
o^. 5�::T _,,7 h'. ,4,....- $ ,.+
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§ ,
DESI
NER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Nam121
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Name:x
Addrss:
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Address:
City:oyyai
PaM Bech Mate:FLCity:
State:
Zip:
Phone30587M541
d
Zip: Phone:
FEE
iMPLE TITLEHOLDER: __)L Not Applicable
BONDING COMPANY: Not Applicable
Nam
Name:
Addr
address:
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City:
City:
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Phone:
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Zip: Phone:
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OWN / CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certif that no work or installation has commenced prior to the issuance of a permit.
St. tuci Coun' makes no representation that is granting a permit wiff authorize the permit holder to build the subject structure
which`i �►rr conflict with" any applrcable Home Owners Assoc►ation'rules, bylaws or and covenants that may restrict or prohibit suclr
structuII;I . Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consiperation of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accor dance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The foll Ilwing building permit applications are exempt from undergoing a full concurrency review: room additions,
accesso -jy 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 twfa for
Improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
befor�the first inspection. If you intend to obtain financing, consult with lender or an attorney before
comm, ncing work or recording your Notice of Commencement.
Signa
re- of bfvneO Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STA
COU
OF FLORIDA
TY OF
STATE OF FLORIDA
COUNTY OF
The fo
this
ping:instru ent.w1-6as acknowledged efore me
li day of 20IN by
The for ing instrum t was.acknowiedap-a� before -me
this M'day of" 20 by
Name of person making statement
ally Known OR Produced Identification 1V"'
Name of person making statement
Personally Known Z OR Produced Identification
Perso
Type
& Identification
Type of Identification
Produced
Produced
(Si g
Coat
ure of Nota*F,,61ric-S r�
NOTARY
Sion Eta.Fffi
(S' ature of Notary Publicj&FIo*W*m &.Ingi it sm.
NOtARYf'IIBLIC
Co`►i`rmission No�. $T*M40 FLORIDA
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