HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �� (� SCANNED Permit Number:
BY
• Sf. LwiPrnnnih, RECEIVED
Building Permit Applicat on SEP 17 209
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Per ing
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772).462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 4901 Green Dolphin St
Property Tax ID #: 1301-601-0046-000-6
Site Plan Name: Donohoe
Project Name: Donohoe
Lot No.15
Block No. 4
I DETAILED DESCRIPTION OF WORK: I
Inground Swimming pool and Deck
I CONSTRUCTION INFORMATION: ' ` ' " '" " I
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters -Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Constructiori:
Cost of Construction: $ 3 (iSSsi •f� a
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Judith M Donohoe
Name: Wade M Clarke
Address: 4901 Green Dolphin St
Company: Horizon Pools Inc
City: R Pierce, Florida State: _
Zip Code: 34951 Fax:
Phone
�
Address: 6423 Stately Oaks St
City: Ft Pierce State: FL
Zip Code: 34981 Fax:
Phone No 7728018510
E-Mail:
I I ( 1�
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mal • t
anzord DAS.Sard
State or County License CPC1458644 m ��
IT vame or construction is SzsUU 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Na me• M RANDALL ROGERS
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address: 1801 HAZELWOOO DRIVE
City: FTPIERCE State: FL
Zip: 34882 Phone 772-20,-,csa
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
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 Counri 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 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
POS9.ONHE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
m T
OUR ENDER OR AN ATTORNE"EFORE RECORDING YOUR NOTICE OF COMMENCEMENT-"
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Signature of Contractor/License Holder
Si of Ow r Less a/Contractor as Agent for Owner -
STAT OF F RID /I.,,,
COU w C Gl� �1�
STATE OF FLORIDA � �
COUNTY OF
The forgoing instrunyknt was acknowledged before me
The forgoing instrumint was acknowledged before me
this 3 day of L by
this day of 20--�9 by
I20
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C.Q.
Name of person making statement.
Name of person making statement.
OR
Personally Known OR Produced Identification
Personally Known Produced Identification
Type of Identificati
Type of Identification
Produced JZ�
Produced
a
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IS ature of Notary P et Iyr1PJR�
(Sign re of Notary Public -State of Fjof} a )
TATEOF FLORIDA.
' ' Jda Aft A, �
Commission No. fto&M
Commission N NOTARY.PUBLRXSeal)
Expires 3f812020
STATE OF FLORiOq
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