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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE CO.ILPLETED FOR APPLICATION TO BE ACCEPTED Date: 1/7/2019 Permit Number: MW t . U/9 G�A_P►_�7F_ 3C �EDuedaN Building Permit Application eY si) O6u Planning and Development ServicesN Building and Code Regulation Division t' Lucie CO,11h� O Vl 2300 Virginia Avenue, Fort Pierce FL 34982 x �� zab Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential / PERMIT APPLICATION FOR: Pool inground LI III Address: 7703 Citrus Park Blvd Fort Peirce, FL 34951 Legal Description: Lake Park-Unit-7-BLK 74lot 15(map 13/02N) (or 3453-594;596;3455-956;3463-2795) Property Tax ID #: 1301-607-0122-000-1 Site Plan Name: Project Name: Cubow Residence Setbacks Front r Back:. Side: A Left Lot No. Block No. DETAILED DESCRIPTION OF WORK: In Ground Pool in Back Yard CONSTRUCTION INFORMATION: III 11HVAC UGas Tank R] Electric 0 Plumbing Total Sq. Ft of Construction:"SOFM Cost of Construction: S S 3, S_00 Piping _Shutters ❑Windows/Doors nklers 11 Generator E] Roof = Roof pitch S Ft. of First Floor: Utilities: Sewer©Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Joe cubow Name: Jared Odom Address:7703 Citrus Park Blvd Company: Odom Custom Pools City: Blvd Fort Peirce, State:FL Zip Code:34951 Fax: Phone No. Address: 1056 Old Dixie Hwy City: Vero Beach State: FL Zip Code: 32960 Fax: Phone No. 772-473-9692 E-Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail: Jodom@odomcustompools.com State or County License: CPC1458195 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN, LAW INFORMATION: DESIGNER/ENGINEER: -Name: ✓eg0,r-"r'aGJS _ Not Applicable MORTGAGE COMPANY: 4 Not Applicable -Name: — ----- - Address: /5' r6 / o✓/h Address: City: Sf Palm S-6 G$_ Zip: 73 y / i Phone 3oS- State: L - V 75 -DSy/ City: State: Zip: Phone: FEE SIMPLE TITLEHOLDER: Name: 2—Not Applicable BONDING COMPANY: )z Not Applicable Name: Address: 1056 old Dude 1JmY Address: 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 recordine vour Notice of Commencement. Signatur Owner/ Lessee/Contractor as Agent for Owner Signature of C tractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this _&14 day of S nuc. 4 20jft by this -g,± day of vA� 20_Ly by — / e o pe on making statement a of person making statement OR Produced Identification e y K OR Produced Identification Type of Identification o Identification Produced 'A6" Produced (Signature of Not - (Signatilre of Notary Public- State of Florida ) Commission No. ,; RORERTAM.MILLER : •. &"t`'s NotaryNW;c4Sead)Rorida Commission No. +'�'""' •"•. RORERTAq$1Q� e •', ` CommWon1GGINS30 '; ' •• My Comm.E>tpir6Ju19,2021 , N6tary Publk-StateofFlorida , Commis 'ton GG 122530 e,. gardedtlwughNaEaraltararybsr. MyCOmm.EtpiresJu19,2021 mmugh NaEanalNot ry psyN REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEAT R L ROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17