HomeMy WebLinkAboutBUILDING PERMIT APPLICATION'1 .
ALL PPLICABLEIINFO
JMUST BE COMPLETERFOR APPLICATION TO BE ACCEPTED -
Date: �"/ J v Permit Nurn_ _ ---
Building Permit Applica`tio SEP 19 2038
Plan ing and Development Services
Building and Code Regulation Divisionen
230 . Virginia Avenue, Fort Pierce FL 34982 S t. LU C I - County, (= L
Pho, e: (772) 462-1553 Fax: (772) 462-1578 Commercial -
PER' APPLICATION FOR: Pool inground
PROPOSED IMPROVEMENT LOCATION: P
II 3058 NW RADCLIFFE WAY PALM CITY, FL 34990
Address:
Legal description: RIVERBEND (PB 67-36)- LOT 16
Pro
Site
Pro
V Tax I D #: 4425-703-0021-000-8
iName: DL &(Z-57 _0 10004--
Name: � I:Li:A-5,-1-CA) PV i-
cs Front Back: Ri Side: Left Side: lt"�
DETAILED DESCRIPTION OF WORK:
CONS;t RUCTION OF IN GROUND SWIMMING POOL AND PAVER PATIO
Lot No.16
Block No.
CONSTRUCTION INFORMATION:
it na wor to e ne orme under this pgrmit - check a apply:
HVAC LJ Gas Tank []Ga5 Piping _ Shutters Windows/Doors
ClElectric Plumbing 11Spri,pklers' Generator ❑_ Roof
Total Sq. Ft of Construction:S : Ft. of First Floor:
Cost oI� li Construction: $ 11�! Utilities: Sewer OSeptic Building Height:
OW ER/LESSEE:
CONTRACTOR:
NameIF:OBERT DUERSTEN
Name: JOHN M. MAY
': ' 5-8 N � Qa��trt. r� �C)A �
AddrZi-M
Company:'JM CUSTOM POOLS INC
city: C /r%/ State: L
Address: 3134 SW DIMATTIA STREET
Zip Ede: 3 y 17 C Fax: 7 7,2 -S yb-- Y 7V0
City: PORT ST. LUCIE State:
Phon� No.-fy( t- (, 26-_ aOV3
Zip Code: 3.4953 Fax: 772-207-5481
E-Mai :
Phone No. 172486-0821
Fill in fil ee simple Title Holder on next page (if different
E-Mail: Jmpools@bellsouth.net
from he Owner listed above)
tl
State or County License: CPC1458456
If valuel of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESfGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY: Not Applicable
Narr}�e:
_
Name:
Addess:
Address:
City:i
State:
City: State:
Zip:
Phone:
I
Zip: Phone:
FEE ;SIMPLE
TITLE HOLDER:
_ Not Applicable
BONDING COMPANY: Not Applicable
Ad
Zip: II Phone:
Name: _
Address:
City:_
Zip:
that no work or installation has commenced prior to the issuance of a permit.
Phone:
St. 4ie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which lis 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 corlsideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accprdance 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,
accet ry structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WAF WING 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
comrnencine work or recordirw vour Notice of Commencement;, l
Vic, 41111( � .
Signalu'fie—of Owner/ Agent/ Lessee Sign Iture of Contractor/ Icense er
STATE OF FLOR .. � `� STATE OF FLORIDA
COU TY OF �1_:, 1.1�1 1 COUNTY OF
The for o' g rostrum�n t was acknowledged before me
The f Ting instr ent was a knowledged before me 4r
this day of 20 by this d y of /5` 20_A by
7-0 Ab 4r6-X
(Nam''of person a knowledging) (Name of person acknowled ng )
(Si i W I
ure of of ry Public- S at of Florida) (Signature of Notary Public- State of F da )
Perso1ally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of identificatioA Produced
11`731Q G
Commission No. e I o sion No. `"'.':'••. LLIAM H��i%OVAN JR
PU
Notary Public State of lodda :gyp
Kaylin J May ;'F MY COMMISSION # 00093576
of p�o� Explres 10103l2019 "' 4;,,,•`�,
Revised 07/15/2014
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
1I
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
I
COMPLETE
O
INITIA
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