HomeMy WebLinkAboutBUILDING PERMIT APPLICATION,ALL�AF,PLICABLE INFO MUST BE COMPII D FOR APPLICATION TO BE ACCEPTED
Date: SCANNED Permit Number: \`\ 10'd3�S
BY RECEIVED
St. Lucie County
Building Permit Application
Planning and Development Services ST. Lucie County, Permitting
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 III
Address: IU.711-1
Legal Description:
Property Tax ID #:
Site Plan Name•
Project Name `-
Setbacks Front Back: ka i Right Side: -I b ' Left Side:
Installation of Gunite Pool, Deck and Equipment
0HVAC LJGas Tank
ZEiectric Plumbing
Piping 1 1Shutters
Generator
Total Sq. Ft of Construction: rJ .5750 S�Ft.( of First Floor:
Cast of Construction: $ 5-1 . �Wl Utilities LJ Sewer ElSeptic
Lot No. k_
Block No.
aWindows/Doors
0 Roof
Building Height:
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Name I
Name: Terry Wix
Address: ID'7ILI ly- vtDyVf-,� 1&%A i
Company: Pools by Greg. Inc.
city: V'-) I _ State: _ L
Zip Code: SLtQ ho Fax:
Phone No.AT) . AMI - '511 ti
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 constructiori is $2500 or more, a RECORDED Notice of Commencement is required.
l 1
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
Designer/Architect/Engineer: ❑ Not Applicable Mortgage Company: a Not Applicable
Name M . (� �p J_ n 11 �O G r (S Name
Mailing Address R, D I HL 2r I 1 n D f� R . Mailing Address
City 'FE) r t P i i r•C e— State �E City State
Zip 3yq19 aPhone ':t�+a—a01—IIn3`i Zip Phone
Fee Simple Title Holder's Name: S Not Applicable
Name
Mailing Address
City State
Zip Phone
Bonding Company: S Not Applicable
Name
Mailing Address
City State
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 architect/engineer 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.
Y �
gnaW% D 'Mgelf LessR-31
STATE OF FLORIDA
COUNTY OF MARTIN
The foregoing instrument was acknowledged before me
this�dayof 6Ct ,20-Kby
ry'V \w\,X
(Name of Person Ackn wIedging)
(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
FBC 5th Edition (2014)
Notary Public State of Florida
A Thomasina Bowins
rn m,ion GG 201733
�Sigrlittare of,Cs hactoi/Ltcensriliol`d'er'�"
STATE OF FLORIDA
COUNTY OF MARTIN
The foregoing instrument was acknowledged before me
this-1day ofbc {- ,20_Aby
(NameofPerson Ackno led g)
(Signature of of Notary ublic—State of Florida)
of Florida)
(Print, Type, or Stamp Commissioned Name of Notary Public)
Personally Known _�C OR Produced Identification
Type of Identification Produced
201733
162,11ILI f r
Application.Doex Rev.