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Home My WebLink AboutBUILDING PERMIT APPLICATIONI ' FOR APPLICATION TO BE ACCEPTED (UYIPermit Number: li Q SCANNED BY RECEIVED St. Lucie County Building Permit Applicati n APR 12 ST. Lucie Coun Commercial Residential X I J All APPLICABLE INFO MUST BE COMPLETED Date: 1 4 — — -- - Planning and Development Services Building and Code Regulation -Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 I 2019 ,-Permitting PERMITTYPE: New gunite 1pool with concrete deck PROPOSED IMPROVEMENT LOCATION: Address: 12739 Refuge Lane, Jensen Beach.F134957 Property Tax ID #: 4504-702-0003-000-5 Site Plan Name: Anne L lanniccheri Project Name: Anne L lanniccheri i Lot N 12 i Block No. i I DETAILED DESCRIPTION OF WORK: New pool construction (gunite) with concrete deck CONSTRUCTION INFORMATION: Additional work to be performed under this -Mechanical _ Gas Tank —Electric _ Plumbing Total Sq. Ft of Construction: Cost of Construction: $ 27,000.00 permit— check all that apply: _ Gas Piping _ Shutters _ Windows/D _ Sprinklers _ Generator _ Roof Sq. Ft. of First Floor: Utilities: —Sewer _Septic Building Height: I ors Pitch F OWNER/LESSEE: i CONTRACTOR: NameAnne L lanniccheri I Name:Rob Colasurdo Address:12739 Refuge Lane City: Jensen Beach I Company: Pool Doctor of the Palm Beaches. Address:1408 N Killian Drive Suite 103 City: Lake Park State: State: _ Zip Code: 34957 ` Fax: Phone No.772-361-5061 E-Mail: FI I Zip Code: 33403 Fax: 561344 0276 Phone No561-586-2815 E-Mail customerservice@pooldoctorpb.com I 1 Fill in fee simple Title Holder on next page from the Owner listed above) (if different State or County LicenseCPC1458452 I If value of construction Is $2500 or more, a RECORDED If value of HVACjs $7,500 or more, a RECORDED Notice of Commencement is required. Notice of Commencement Is required. 1 SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: I Address: I Address: City: 1State: City: Sfiate: _ Zip: Phone I Zip: Phone: I I FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable Name: I NamP. Address: i Address: I City: I City: I Zip: Phone: I Zip: Phone: I I i 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 thaiis 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 wor 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 COMMENC�ENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFOREITHE FIRST INSPECTION. IF YOU IINTENO TO OBTAIN FINANCING, CONSULT wITN YntIR.I FNnFR nR AN A9TnDNry orvnor orrnonlur vnrnmXt*rlrr c nYYrurcuru n i :Signature of OwnFerr//LLeessee/Contractor as Agentfor Owner Signature f ontractor/License HolderSTATE'OF II "a'Gc,C I STATE 0 COUNTY OF. COUNTYOFORIDA-7 The forgo g instrurt�gAt waspcknowledge this of //fQ'rGGc 20 efore me by The forgoing instrument wa acknowledg before me ay this day of r 20t by n /fnAWE 1A 07)1"'I1G(. i �� n tC(i✓Lc✓% \�P)l(1`�L�rP 8 Name of person making statement. Name of person making/statement. Personally Known OR Produced Identification _,A_ Personally Known V OR Produced Identifirai ion Type of Identification Type of Identification Produced Produced MITCH Bococ otarypubllc-sta (SignaureofNotaryPublic-Stat oFs" ,�. Notary Public - Stat Pfau. of NotaryPublic- Stateo o •.•,,,oF o :=' MY I mmisslona000 ComM FxpimsJul Commission No. J =,y� "S' ( lJ Commission # F 9 Oz_338_. 81Ad on No. dih�ugh NeHonrl , '•d;... OF f, My Comm. Expires D cWfr'jU REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MPNGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE j RECEIVED { DATE COMPLETED j nev. L/ // 17