HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONt AUk,4PPLIICABLE INFO MUST BE COMF iD FOR APPLICATION TO BE ACCEPTED
Dater_ 1 G Permit Number: ,*%VJ5'Oaa-6N
SCANNED
cr BY RECEIVED
® St. Lucie County
Building Permit Application JUN 10 2019
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Pool inground
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Address: qi -A-19 !2 LSD C e-
Legal Description: PO f V 6C%n0 Sh6 Y-eG P V\OLG-6 3 L-Ot Lil -I
Property Tax ID#: 31a - 5o S - (Dow - c)oo -� Lot No.
Site Plan Name: w \ ` -Ne S Block No.
Project Name: VJ 1 KC S
Setbacks Front /b, Back: Right Side: Left Side:
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Installation of Gunite Pool, Deck and Equipment
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Additional work o e e orme under tis perm -checka appy:
11HVAC E] Gas Tank ❑Gas Piping _ Shutters a Windows/Doors
ZElectric ❑Sprinklers E D Roof
Plumbing Generator
Pool : 9t q `t
Total Sq. Ft of Construction: S Ft. of First Floor: De- \<- . q bO
Cost of Construction: $ LI 1F 3 Q0 Utilities. Sewer Septic Building Height:
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Name: Terry Wa
Name V.i \ St K r w rt
Address:3 \i P (�_C c_ I Y--e- O (K
Company: Pools by Greg, Inc.
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City: �a r (- P e rc p. State: �L
Address: 8886 S Federal Hwy
City: Port St Lucie State: FL
Zip Code: S j Fax: IJ 8
Phone No. q y
Zip Code: 34952 Fax: 772-337-9287
E-Mail:—t'j I
Phone No.772-337-9713,
Fill in fee sirnple Title Holder on next page (if different
E-Mail: office@poolsbygreginc.com
State or County License: CPC1458338
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
Designer/Architect/Engincer. ❑Not Applicable
NameM. Rmnrinll KOGt4S
Mailing Address J%t) HCA2el OD C)R.
City girt Qi,rce— State
Zip3y�14aPhone }tea—a0l—Itoii
Fee Simple Title Holder's Name: S 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/engineer 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.
W
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�5igiattie•" ner/tlgen'f/ eSse'�
STATE OF FLORIDA
COUNTY OF MARTIN
The foregoing instrument was acknowledged before me
this +_dayof J\I r4 ➢. 20_ftby
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(Name ofPerson Aclar wledging)
(Signature of Notary Public —State of Florida 'r
(Print, Type, or Stamp Commissioned Name of Notary Public)
Personally Kw nonl7C OR Produced ldentification
Type of identification Produced
Iy N
A Thomasina
201733
UI nafure;oi� tr-fgr„ Ycense
STATE OF FLORIDA
COUNTY OF MARTIN
The foregoing instrume t was acknowledged before me
this day of ,� 204 by
(Name of Person—=1mo l�r �) L
(Signature of Notary Public —State of Florida)
(Print, Type, or Stamp Commissioned Name of Notary Public)
Personally Known C/1 OR Produced Identification
Type of identification Produced
A Thomasina Bowins
T:IBLDIBldg_FormsWewApplications\ApplicationslBuildingPermit Application.Docx Rev.8/10/15