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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALCWPLI'CABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: No-z-o`� Permit Number:
RECEIVED
e
Building Permit Application OCT 3 0 2010
Planning and Development Services 9T; welt Gdlltityi Mfri:iltrli�
Building and Code Regulation Division'�T--`
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT'APPLICATION FOR: Pool inground SCANNED
P.ROPOS'ED IMPROVEM:ENT.LOCATION'
St Lucie Co
Address: P I d Cam/ 3 V9
Legal Description: Pr
Property Tax ID #:L'� '��- �-L �.,a i� Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side:„ Left Side: �©
DETAILED DESCRIPTION OF WORK;
INSTALLING A SWIMMING POOL �L ` 01'4
lZ > Ll /f 1116 10A0V/ 40�>� iiy rtoZ/s f� �Z��r ��r2,rd� i�i 8o� - 63 y8)
CONSTRUCTION INFORMATION:
Additional work to be performed • under this permit— check all apply:
F]HVAC Gas Tank Gas Piping _ Shutters D Windows/Doors
® Electric 0 Plumbing Sprinklers Generator E]Roof Roof pitch
Total Sq. Ft of Construction: 1^�M
Lost UI I.VIIJLI UI.tIUll. .7 ��' �Jy��
11 1.1 S(]}1I�Ft7�I of First Floor:
ULIIILICJ. L_===JJCWCI Septic
DUIIVIIIg nelgIII.
OWN ER/LESSEE: - =
CONTRACTOR;
Name &.4ito A/
Name: BARRY MILLS
Address: t= 510 S MIA ✓ 0r'0C--
Company: CRYSTAL POOLS
City: r44 P, Ctice— State:
Address: 4680 US1
Zip Code: I Y Fax:
City: VERO BEACH State: FL
Phone No.
Zip Code: 32967 Fax:
Phone No. 772-567-3067
E-Mail:
Fill in fee simple Title Holder on next page ( if different
E-Mail: JIMMYR@CRYSTALPOOLSIRC.COM
from the Owner listed above)
State or County License: CPC#1457120
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL C,ONSTRU_CT10N-LIEN LAW INFORMATION:-
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: C.ilf2T11 S �//vC-
_
N am e: BARRY MILLS
Address:! 8zsg N, 014154i2'7
7MI L
Address:
City:
State: 4:Z.
City: VERO BEACH State:
Zip: 331fl'3 Phone S6)
-630— 353-Y
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY: Not Applicable
Name: I
Name:
Address:!468o us,
Address:
City: I
City:
Zip: I Phone:
I
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify thaf 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. Piease 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, 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
improvemients 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 your Notice of Commencement.
dehi-) &)TWA At_44
er/ Lessee 'ontractor as Agent for Owner Signature of Conty ctor/License Holder
STAWq OF FLORI` STATE OF FLORIDA
CO TYIOF EWtat—d COUNTY OF s4z C &oe.A_ 6>-41
The forgoing instrument was acknowledged before me
this N.day of &cX6\,oe 20_; by
i
Nbme of pegsin statement
Persona llylKnown J M u'.00MA
Type of Identification '_ Commission # GG
132141
Produced "' 11
Expires November i6. 2021
6"&1 TIwTroyFeln lawtinoe 800 M
i
(Signature; of Notary Public- State of Florida )
Commission No.
fiber 1E
ins
FRONT I ZONING SUPERVISOR
COUNTER I REVIEW I REVIEW
DATE
RECEIVED
DATE
COMPLET
Rev. 8/2/17
The forgoing instrument was acknowledged before me
this _S7 day of 24- by
Name of per on ing statement
rsonally Known OR Produced Identification
pe of Identification
My COMMISSION 6 GG 006627
vrx lgr :November4swal)
Bonded Thru Notary Public Underwriters
VEGETATION f SEA TURTLE 1 MANGROVE
REVIEW REVIEW REVIEW