HomeMy WebLinkAboutBUILDING PERMIT APPPLICATIONr
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SS .,z `I q SCANNED Permit Number: Nmot _dOGO
s L� St. Lud C®unty BY REI
---- - -= AU6Building Permit Applicatio Planning and Development Services stt .Lucie Citting
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
PROPOSED IMPROVEMENT LOCATION:
Address: 18003 BRIDLE WAY
Legal Description: CARLTON COUNTRY ESTATES PB 46-29 LOT 22 - 3727-1980
Property Tax ID #: 3211-701-0024-000-3 Lot No.22
Site Plan Name: Block No.
Project Name: BEATH
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: T III
CONSTRUCTION OF INGROUND POOL AND PAVER PATIO
ON INFORMATION:
HVAC U Gas Tank UGas
Piping
U Shutters ❑
Windows/Qoors
Electric U Plumbing
Sprinklers
Generator
Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 3GA00 0 Utilities* Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name MIKE BEATH
Name: JOHN M. MAY
Address: 18003 BRIDLE WAY
Company: JM CUSTOM POOLS
City: PORT ST. LUCIE State:FL
Zip Code: 34987 Fax:
Phone No.
Address: 2503 DYER ROAD
City: PORT ST. LUCIE State: FL
Zip Code: 34952 Fax: N/A
Phone No. 772-240-3268
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: JMPOOLS@BELLSOUTH.NET
State or Con y License: CPC1458456
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: M. RANDALL RODGERS, P.E.
MORTGAGE COMPANY:
Name:
_ Not Applicable
AddresS:1801 HAZELWOOD DR.
Address:
City: FORTPIERCE, State: FL
Zip: Phone:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY:
Name:
_Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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 I will, in all respects, perform the work
in accordarice 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
STATE OF FLORIDA
COUNTY OF ST.LUCIE
The for oing instrumeZA-T/
edged before me
this�day of 20�by
1� r(Name of person acknowled ng ) O
(Signature of Notdfy Public- bfale of Florida )
Personally Known X OR Produced Identification
Type of Identificati n Produced
Commission
Revised 07/15/2014
STATE OF FLORIDA
COUNTY OF ST.LUCIE
The forgoing instrurr��Rn was acknowledged before me
this day of , 20__Lig by
1U41 PlA,r
(Name of person acknowledg' g )
(Signature of Notary - S ate of Florida )
Personally Known OR Produced Identification
T f Identificati n Produced
IN�n !e o. � _i a
COMMISSION p G093b ssion No.
EXPIRES April 12. 021
WILLIAM H DONOVAN JR
MYCOMMISSION N GG093574
EXPIRES April 12. 2021
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