HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: l� 119 Permit Number: /IIIIIIIIIIh
SCANNED
BY FR!/ESt. Lucie CountyBuilding Permit Appl 20)9
Planning. and Development ServicesBuilding and CodeRegulationDivision epartment
2300 Virginia Avenue, Fort Pierce FL 34982 FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT TYPE:SWlll Ming Pool
PROPOSED -IMPROVEMENT LOCATION: -
Address: 4780 Jo
Property Tax ID #:
Site Plan Name:
Project Name: _
A Fort Pierce, FL 34982
DETAILED DESCRIPTION OF WORK: `
Swimming Pool
Lot No.
Block No.
CONSTRUCTION INFORMATION: '
Additional work to be performed under this permit - check all that apply:
Mechanical G�asTank _Gas Piping _Shutters
Y Electric '� Plumbing _Sprinklers _ Generator
Total Sq. Ft of Construction: Q+3Mf /,MS Sq. Ft. of First Floor: _
Cost of Construction:$ 8 yy`18�1gx Utilities: _Sewer _Septic
Windows/Doors
Roof Pitch
Building Height: -7-
OWNER/LESSEE: -
CONTRACTOR:
Name Brandi Pearson
Name:
Address:4780 Jorgensen Road
Company:
City: Fort Pierce State: _
Zip Code: 34981 Fax:
Phone No.772-528-2392
Address:
City: State:_
Zip Code: Fax:
Phone No
E-Mail:brandi.pearson85@gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail
State r County License
If value of construction is $250D or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
v-
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name: - 1 rn
_ Not Applicable
n
MORTGAGE COMPANY: _ Not Applicable
Name:
Addre s: Z3 S
Address:
City: ift)
Zip: C%RU9 Phone L*
State: .!
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER:
Name:
_Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Address:
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 1 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
YWfiH. YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMEWCEMENT."
&od,L-1/
`
Signature of Owner/ L ssee/Contracto as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLOW
COUNTY OF
COUNTY OF [ P/
The for oing instr m .nt was acknowledg d efore me
May �
The forgoing instr t was acl� nowledged before me
20� by
this of 20I by
,?7 of ,1_i JPR. r pt� n
this�dayof
Name of person making statement.
a of person making statement.
/
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of idetrtifi t n
Type of Identie n
Produced
All
Produced_, 1L1� t,
A"- 10KA4qa)0" -
( ignature of
(S nature of No a Public- State of Flori
P HREV
Commission No.
AUDREYB.
:,; MYCOMMISS Ir3�817 i
2023
Commission N +•:?"?:"•�. AUDREYB.H N .$
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MY COMMISSION�GG W817
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:.: X IRES:March6,2023
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REVIEWS
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REVIEW
DATE
RECEIVED
DATE
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