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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED . � Date: OU t� t� Permit Number: RECEIVED Building Permit Application Planning and Development Services NUV o f 2016 Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 ST, 6adA County, Permitting Phone:! (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x PERM IT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address! Legal Description: 1�� wN7 JI) S I vT � u,,ty Property Tax ID #: Lot No. Site Planl Name: ef- Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: I INSTALLING A SWIMMING POOL 0,J 2,nm CONSTRUCTION INFORMATION: Ada Mo551 work to be n,rformed under this permit— check [HVAC Gas Tank ❑Gas Piping all that apply: Shutters Windows/Doors- Electric Plumbing Sprinklers FIGenerator F]Roof Roof pitch Total Sq. Ft of Construction: S . Ft. of First Floor: I F Cost of Construction: $ =1�,, Utilities: _ Sewer Septic Building Height: OWN ER/LESSEE: CONTRACTOR: Name U f_-M ''i__ Address: gzCz t P�h (; 1c✓%% Name: BARRY MILLS Company: CRYSTAL POOLS City: i State: Zip Code: 6`26a �T/_ Fax: Address: 4680 US1 City: VERO BEACH State: FL Phone No. ,ci Zip Code: 32967 Fax: 7 E-Mail:. Phone No. 772-567-3067 Fill in fee simple Title Holder on next page (if different from the Owner listed above) I E-Mail: JIMMYR@CRYSTALPOOLSIRC.COM State or County License: CPC 1457120 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. A ©0 r IF•tti- SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable Name,. _ N a me: BARRV MILLS Address: Address: City: State: City: VERO BEACH State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name;: Name: Address: Address: 4wo use City: City: Zip: Phone: 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 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 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. Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OFSTLUCIE The for oing ins ent w .acknowledg efore me this day 2QL by The forgoing instrument was acknowledged before me this 8TH day of mARcH , 20_ by o Name of person making statement Name of person making statement Personally Known OR Produced Identification Personally Known x OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of Notary Public- St of Florida) (Signaturerotary PuJAMES r Commission No. .� Notary)StateofFlorida ROUAN My MilASION # GG 008627 COmmissio. *3( '{� 'November Frances My Commission GG 092440 a: %T;oF �� Bonded Thru Notary Public UndarvOters j.m. Expires 07/27/2029 �+ REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE f RECEIVED ( DATE, \ COMPLETED Rev. 8/2/17