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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED U Date: n\ \F `DJ. Permit Number: d 1d 1 _ dyoi Building Permit Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial In APR 16 2019 outAINP BY ST. Lucie County, Permitting St. Lucie ------------- Residential X PERMIT APPLICATION FOR: Pool inground III Address: 15-1 Legal PropertyTaxlD#: 3404- 1909 - 000 / ^ ODD— I Lot No. Site Plan Name: L Q1 \A SO r\ Block No. Project Name: LAWS Setbacks Front N / n Back: Right Side: 6 S 1 Left Side: Q) i Installation of Gunite Pool, Deck and Equipment 1]HVAC I l Gas Tank ❑Gas Piping Electric W1 Plumbing OSprinklers Qco1= 31S Total Sq. Ft of Construction: r-), "'.Lo ( Cost of Construction: $ '::� U 140 r)_ 0n Shutters Windows/Doors Generator Roof S Ft. of First Floor: _ Utilities: 0 Sewer 0 Septic Building Height: z gar m� r'+ � _Gf11��z �a:ki> S n t� r wsq. a-r t tv ti:,•'s` Yb£_%i..n k t*f i.5IN,s.$� 'ka._. s M1'`z. ''d O v Name S� L u>sb Name: Terry WV / Address: 25)r-i lam!Ir �Ph) Yl I.i aAl Company: Pools by Greg, Inc. City: Hbr�' Z3P IF S Zip CodeO 3 Fax: Phone No. -3flf & Address: 8886 S Federal Hwy - City: Port St Lucie State: FL Zip Code: 34952 Fax: 772-337-9287 Phone No. 772-337-9713 E-Mail: / IyI 0. - La tJ�I? l_ VY% I • cpm Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail: office@poolsbygreginc.com State or County License: CPC1458338 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL LIEN LAW INFORMATION Designer/Architect/Engineer. ❑ Not Applicable Name M. RexqJelll BOGY f S Mailing Address Ol H t o 0 f7R. City T�n r t P i t rc e, State Zip 3t-Iq 4a Phone -�fta—a01— I In SH Fee Simple Title Holder's Name: A Not Applicable Name Mailing Address City State Zip Phone Mortgage Company: 11 Not Applicable Name Mailing Address City State Zip Phone Bonding Company: A Not Applicable Name Mailing Address City State Zip Phone Notice to Owner. There are some properties that may have deed restrictions recorded upon them. These restrictions may limit or prohibit the work applied for in your building permit It may be to your advantage to check and see if your property is encumbered by any restrictions. Owner/Contractor Affidavit: Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit. 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 Code 5th Edition (2014) and Martin County Amendments. Plan revisions on all structures exempted by code from architect/engmeer design may be done by permit holder - 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 job site before the first inspection. If you intend to obtain financing, consult with your lender or an attorney before commencing work or recording your Notice of Commencement. I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. �SlgnatuR1of,Oii 'er/AgeiWL ssee STATE OF FLORIDA COUNTY OF MARTIN The foregoing instrument was acknowledged before me this Ie day of 20LIby 72 rr\I \&N%X (Name of Person Ac�edgin g) (Signature of Notary Public —State of Florida) (Print, Type, or Stamp Commissioned Name of Notary Public) Personally Known ' )4 OR Produced Identification Type of Identification Produced FBC 5th Edition (20 A Thomasina gowns My Commission GG 2o1733 Expires o3f2912e22 [Srgna ur optiac6 rfC ioenseHofdR) STATE OF FLORIDA COUNTY OF MARTIN The foregoing instrument was acknowledged before me this 1,15 day of A r.1 .20AI by (Name of Person Ackno ledging) (Signature of Notary Public —State of Florida) (Print, Type, or Stamp Commissioned Name of Notary Public) Personally Know x OR Produced ldentification Type of Identificatton Produced late of Florida Bowins ► jlz «4 Permit Application.Docx Rev. 8/10/15 0