HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MVST_BE J-f LETED FOR APPLICATION TO BE ACCEPTI' ( �n �O'
Date: SCANNED Permit Number: 111
�:.., BY
St. Lucie County
® RECENED
Building Permit Application OCT 09 7019
Planning and Development Services
Building and Code Regulation Division Permitting department
2.300 Virginia Avenue, Fort Pierce FL 34982 5t. Lucie County
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Pool inground III
Legal Description:
Setbacks Front Back: Climb Right Side: ,d5 - to' Left Side: "J�
Installation of Gunite Pool, Deck and Equipment
HVAC Lj Gas Tank (JGas Piping
LJElectric OPlumbing ❑Sprint
Total Sq. Ft of Constructio�bDl'.45p
Cost of Construction: $ '9)0i An
Lot No. I
❑ Shutters ❑ Windows/Doors
❑ Generator ❑ Roof
S Ft. of First Floor: _
Utilities:12Sewer ❑Septic
Building Height:
"C
A `� H+ z-s -.. •'^+Sp`c'KI'�1
n4.j�
Name
Name: Terry Wix
Address:I35
Company: Pools by Greg, Inc.
City: j�f' V I YU State: FL
Zip Code: "�L4415D Fax:
Phone No.-5(pt '?:a4 • QC3LI
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 is required.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION I
Designer/Architeet/Engincer. ❑ Not Applicable Mortgage Company: 11 Not Applicable
Name M . R r� n.� S - Name
Mailing Address _�_ D I �,Ct 2r I O D (7 R . Mailing Address
City fn r t Pit rc e- State FL City State
Zip' t,L4I4a Phone `}�Ira-a01- I [n 3y Zip Phone
Fee Simple Title Holder's Name: A Not Applicable Bonding Company: A Not Applicable
Name Name
Mailing Address 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.
1 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.
W
Signatu[e o by ' erit/Le`ssee
STATE OF FLORIDA
COUNTY OF MARTIN
The fate o)ng ins aril was acknowledged before me
this day of tg / Oct 20Pby
17�rY'\I \w\:X
(Name of Person Ackn wledging)
(Signature of Nobry Public —State of Florida)
(Print, Type, or Stamp Commissioned Name of Notary Public)
Personally Known OR Produced Identification
Type of Identification Produced
i�S gnaT ttir it`rector/tLrc &Vie=Holder`-
STATE OF FLORIDA
COUNTY OF MARTIN
The foregoing instrument was acknowled&ed before me
thisdayof 20A by
l� �fV \`1rJC
(Name of Person Ackno%ledgingg))��/-t
(Signature of Notary Public —State of Florida)
(Print, Type, or Slump Commissioned Name of Notary Public)
Personally KnownORProduced identification
Type of Identificatiml Produced
FBC Sth Edition (I I'%�r o Notary Public State of Ronda =oOT�� Notary Public State of Florlda
°^ A Thomasina Bowins A Thomasina Bowins
�jN.. my Commission Gu 20 1 133 d j-
"�ola°� Expires 03/29/2022 ora Expires 03129/2022
T:\BLD\Bldg_FormsWew Applications lications\Building Permit Application.Docx Rev. 8/10/15
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