HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONBP #: OMF 0097
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INITIALS
DATE FILED: 's I1 0,2
PLAN REVIEW FEE: tOn •Da RECEIPT NO.: tASI S PERMIT NUMBER: OW- 6(j0 .
CONCURRENCY FEE: RECEIPT NO.: CERT. CAP. NO.:
ALL INFO MUST BE COMPLETE 8t FILLED IN TO BE ACCEPTED
1
C\6 CpG �1 ��NED
y ST. LUCIE COUNTY PUBLIC WORKS U �tlS�d
BUILDING & ZONING DEPARTMENT BY b�
2300 VIRGINIA AVENUE ' ' Bt. LudeCoUn
�OR1DQ' FORT PIERCE, FL 34982-5652
772-462-1553
APPLICATION for BUILDING PERMIT
CERTIFICATE of CAPACITY/ZONING COMPLIANCE
LOCATION/SITE ADDRESS:
2_ S/D NAME:
3. PROPERTY TAX ID #:
PROJECT INFORMATION
SITE PLAN NAME:
ALL OF
4_ LEGAL DESCRIPTION (attach extra sheets ifnecessary):jZ:Cum
Te A%11e--%sadTH,RAtJBE2/o,5AgTr. kC0RbMNd-r07Ye PL,07-7h
�R P�&5089MOF T -rs e IT FkopabA•4,s >+•77
5. PLAT. 6. PAGE 7,
BOOK r1� NO. L3�
43
10.
I-E83AN�EXOEPTTI-IESCtITiH ICiFcfTl4N�ROFfD
wa i1�KKoxlaE 2tiJPLffTBooK1�PA6tE35�OFTHE
s QFP\ccaRt�'.
BLOCK 8. LOT
NO_ J NO.
PARCEL SIZ ACRES SQ FT. �w� LOT DIMENSIONS V J9.0'
DESCRIPTION OF CONSTRUCT31_" 0 .
ION PROJECT OR WORK ACTIVITY:
33o/
SWIMMING POOL & DECK
11. SETBACKS (ACTUAL) FRONT: BACK: / RIGHT / LEFT
SISIDE: �A�O
12. TYPE CONSTRUCTION (Check all appropriate boxes)
7NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION
[ ] RESIDENTIAL [ ] COMMERCIAL [ ] INDUSTRIAL
[ ] OTHER (SPECIFY)
13. DESCRIPTION OF PROPOSED USE: RESIDENTIAL
14_ Sq_ Ft./CONSTRUCTION: 15. SSgq. Ft.
�Ist Floor.
16. VALUE OF CONSTRUCTION: $��
The value of construction Is used to determine the amount of permit fees to be assessed. SL Lucie County reserves the right to question and/or modify the
Indicated value of construction if it is demonstrate that the submitted figures are riot coiLsistent with similar types of construction activities. If the value is $2500
or more, a RECORDED Notice of Commencement must be submitled with this application.
3LCCDV Form No.: 001-02
OWNER INFORMATION*
NAME:
ADDRESS:
CITY:
PHONE (DAYTIME):
(rnpl %7-3-'a DLA
- CERTIFICATION: -
IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE FILL IN NAME AND ADDRESS
BELOW.
FEE SIMPLE TITLEHOLDER:
ADDRESS:
CITY:
PHONE (DAYTIME): 1 1
CONTRACTOR INFORMATION
STATE:
ZIP
ST. of FL REGJCERT #: CPC - 057200
ST. LUCIE COUNTY CERT #:
1 91 04
BUSINESS NAME: A & G CONCRETE' POOLS,
INC.
QUALIFIERS NAME: ARTHUR H. ALLEN
ADDRESS: 410 SAEGER AVENUE
Coy; FORT PIERCE
STATE:
FLORIDA
ZIP 34982
PHONE (DAYTIME): - 177a 878-7752
FAX NO.
772-467 1 624
ARCHIT/ENGINEER: RAY REINHARD
ADDRESS: OLD DIXIE HIGHWAY
CITY: VERO BEACH
STATE:
FLORIDA
Zip 32960
PHONE (DAYTIME): ( I
BONDING,COMPANY:
ADDRESS:
CITY:
STATE:
LP
- MORTGAGE LE NDER:
ADDRESS:
CITY.
STATE:
ZIP
IMPORTANT NOTICE: When a permit is issued and it is not picked up within 60 days
after notification it will be voided and returned to you by mail.
This application is hereby made to obtain a permit to do the work and installations as indicated, and to obtain a certificate of
capacity, if applicable, for the permitted work. 1 certify that no work or installation has commenced prior to the issuance of a permit
and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. f understand that
separate permits may be required for ELECTRICAL, PLUMBING, SIGNS, WELLS, POOLS, FURNACES BOILERS, HEATERS,
TANKS, AND AIR CONDITIONERS, ETC., not otherwise included with this building permit application.
The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessory
structures (all types), swimming pools, fences, walls, signs, screen rooms, utility substations & accessory uses to another non-
residential use.
NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING
YOUR NOTICE OF COMMENCEMENT.
NOTICE TO APPLICANT: AS THE APPLICANT FOR THIS BUILDING PERMIT, IF IT IS NOT YOUR RIGHT, TITLE, AND
INTEREST THAT IS SUBJECT TO ATTACHMENT AS A CONDITION OF THIS PERMIT YOU
PROMISE IN GOOD FAITH TO DELIVER A COPY OF THE ATTACHED CONSTRUCTION LIEN
LAW NOTICE TO THE PERSON WHOSE PROPERTY IS SUBJECT TO ATTACHMENT -
OWNER'S AFFIDAVIT: 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.
N ONT CTOR SIG TURE CONTRACTOR SIGNATURE
STATE OF FLORIDA
COUNTY OFr' g
The foregoing instrument was acknov
before me thi —day of�tfLY . 20N
who is personally known to me
Type or Print Name of Notary
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged
before me this �1 day of Au w� 2008 , by
�rliR , who is perso ally known to me
or who has produced as identification.
Signature of Notary 1
Type of Print Name of Notary
Notary Public Title
Notary Public Title
C1Y� 1•
'M 11A15aCommission Number
$ commsppm
(seal)fiJ EwIn3s4HtIAlp
BatlbTMp
"' ••^ F•• ••a•NO:a:�:�•k
NOTE: TWO (2) SIGNATURES ARE REQUIRED.
IF APPLYING FOR THIS BUILDING PERMIT
..............................................
(seal) LILLIAN S. SHEPHERD
�.t�grp viy Comm# DD0729752
� Expires 12I412011
EACH SIGNATURE MUST BE NOTARIZED6< ." `<` ��a NotaryAssn., Inc i
AS AN OWNEF2/BUILDER, THE OWNER MUST PERSBNA'Ly7-APPfI=AR
TO SIGN THIS APPLICATION IN THE OFFICE
LISTED ON THE FRONT OF THIS APPLICATION-
J b(ANNED
Code Compliance Division BUILDING PERMIT BY
Virginia Avenue Ft St. Lucie County
Ft Pierce, FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1148
hftp://stlucieco.gov/ce Page 1
Issued: 09/25/2008 Conf A 539 Permit #: SLC- 0808-0097
Job Location: 1103 TILTON RD City: PORT ST LUCIE
Permit Type: Pool/Spa
Job Descrit)tlon: I INSTALLATION SWIMMING POOL & DECK- PE# 0808-0098
S/D St Lucie Gardens S/D Lot: 4 Block: 3 Parcel: 3414-501-0704-000/3
Contractor ALLEN ARTHUR H A & G CONCRETE POOLS INC (772) 878-7752
410 NW SAEGER AVE FT PIERCE, FL 34982
Property Owner WILLIAM K BESSEMER (772) 878-2704
5561 NW THYER CIRCLE PORT ST LUCIE, FL 34983
Setbacks Left:150.00
Number of Units: 1.00
Minimum Floor Elevation:
Right: 118.00 Front: Rear: 779.00 Zoning: RM-5
Floors: 1 Buildings: 1 Square Footage: 0.00
Flood Map: 283F Flood Zone: A Elev: 18.86
Permit holder acknowledges through acceptance of this permit that separate permits must be obtained as required by the Florida Building Code
including those for all electric, plumbing, mechanical, roofing, and structural work. Further, he/she acknowledges responsibility to comply with all
requirements of the 2004 Florida Building Code.
NOTICE: In addition to the requirements in this permit, there may be additional restrictions applicable to this property that may be found in the
records of this County, and there may be additional permits required from other governmental entities such as water management districts, state
agencies, or federal agencies. s:553.79(10), F.S.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
BUILDING IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. s.713.135, F.S.
Christopher Lestrange
Building Official Date
For Automated Inspections, Call (772) 462-1261
For Questions, Call (772) 462-2172
St. Lucie County Land Development Code Section 11.05.01 (A) (2) states; Building Permits shall expire and
become null and void if work authorized by such Building Permit is not commenced, having called for and
received a satisfactory inspection, within six (6) months from the date of issuance of the permit, or if the work is
not completed within 18 months (permit by contractor) or 24 months (permit by owner) from the date of issuance
of the Building Permit.