HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COIM FED FOR APPLICATION TO BE ACCEPTED
Date / D' 9. �-/ SCABNNED Permit Number
St. Lucie County
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce, FL 34982
Phone: (772) 462-1553 Fax: ()72) 462-1578 Commercial
) 9) 0, ocq)`(!
OCT 9 2019
Permitting Departmer
_St._ Lucie County, FL
PERMIT APPLICATION FOR: Pool inground -I11
Address:
Legal Description:
Property Tax ID #:1' 1iw`� (! g ' (= ' h�_I Lot No.�
Site Plan Name: 1� Irn Block No. T
Project Name: 4)1(`ih �1 TT
Setbacks Front Back: ' RightSide:aU n 1—I LeftSide: 0 .n1 2?
Installation of Gunite Pool, Deck and Equipment
UHVAC UGasTank
Electric 0 Plumbin@
Total Sq. Ft of Construction:
C i
Cast of Construction: $ L' V ,�`J
/�
4--
R1 0-og?)
Piping UShutters aWindows/Doors
nklers 1:1 Generator 1:1 Roof
S Ft. of First Floor: _
Utilities:Sewer Septic
Building Height:
iO`ka''a"k.,
ri
jam'' x+ ,,..,,mRm3'S.t#- .+lr�f�Pm`''�'t
li RO.fi ! ; k `s3` G:� � 010
Nam yJn miri-46kt1
Name: Terry Wa
Address: q C Y V
Company: Pools by Greg, Inc.
City: V5I, State:
Zip Code: 5LAS 1D Fax:
Phone No. aD 0 - 9q, • 15M
Address: 8886 S Federal Hwy
City: Port St Lucie
Zip Code: 34952 Fax: 772-337-9287
Phone No. 772-337-9713 ,
State: FL
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: office@poolsbygreginc.com
State or County License: CPC1458338
If value of construction is $2500 or more, a RECORDED Notice of Commencement isrequired.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
Designer/Architect/Engineer.
❑ Not Applicable
Mortgage Company:
A Not Applicable
Name M. R rw n ea
1 S
Name
Mailing Address J 9 D I H(t2e
I 01) d Q.)R.
Mailing Address
City �n r t P i t �C a
State — J= L_
City
State
Zip -I�LM 19a Phone
o �;H
Zip Phone
Fee Simple Title Holder's Name: a Not Applicable
Bonding Company:
A Not Applicable
Name
Name
- MailingAddress- - -
Mailing Address
City
State
City
State
Zip Phone
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 architectlengineer 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.
Srgna m ff '""`!/A enen�sse`e�
STATE OF FLORIDA
COUNTY OF MARTIN
The foregoing instrument ment was acknowledged before me
this___I_dayof 6Ct ,20jqby
T irry kN-'N-X
(Name of Person Ackn wledging) ,(
(Signature of Notary Public —State of Florida)
(Print, Type, or Stamp Commissioned Name of Notary Public)
Personally KnownOR Produced Identification
Type of Identification Produced
�5ignafiae''ofCt GLtcensti'�ofde[
STATE OF FLORIDA
COUNTY OF MARTIN
The oing ins ent was acknowledged before me
this day of 20 i4by
(Name of Person Ackar ledging)
(Signature of Notary Public —State of Florida)
(Print, Type, or Stamp Commissioned Name of Notary Public)
Personally Known � OR Produced Identification
Type of Identification Produced
FBCSthEditi " °� "��"'�����"""�"`�
iL srw.. Notary Public State of Florida i awWE Notary Public State of Flodtla y'
x M i nawpmou e My Commission GG 201733
;�. My Commissicn GG 201733 ct,
'horn Expires 03/2912022 ".� morn Expires 03/29/2022
T:\BLD\Bldg_ilding Permit Application.Docx Rev. 8/10/15