HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE, APLETED FOR APPLICATION TO BE ACCEI'
Date: lO'3�' Ioi SCANNED Permit Number:
BY
.11:r _ x St. Lucie County
RECE
IVED
Building Permit Application
Planning and Development Services OCT
Building and Code Regulation Division ST. Lucie Co
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Pool inground III
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Property Tax ID #/� )Lt� ,- Len-��� Lot Nog
Site Plan Name: La Y CW Block No.
Project Name:
Setbacks Front U Back: IaA.41RightSide: 1W.'bLeft Side: a-�)
Installation of Gunite Pool; Deck and Equipment
0HVAC Ll Gas Tank
❑✓_ Electric Z Plumbing
Total Sq. Ft of Construction:IDf r;1�tLT
Cost of Construction:
Piping UShut ters aWindows/Doors
nklers n Generator 11 Roof
S Ft. of First Floor: _
Utilities:Sewer Septic
Building Height:
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Name Y
Name: Terry Wix
Address:
Company: Pools by Greg, Inc.
City: Ft O1'i y P State: EL
Zip Code: -,JuIQ$'.). Fax:
Phone No.179-t5'a• i SbD
Address: 8886 S Federal Hwy
City: Port St Lucie State: FL
Zip Code: 34952 Fax: 772-337-9287
Phone No. 772-337-9713 ,
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 constructionis $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
Desiguer/Architect/Engmeer. ❑ Not Applicable
NameM. RA-GJnll �OGY1S
Mailing Address 19, DI HC12e I o0 (7R.
city n rt Pi �{c e- State
Zip 3 y �1 �a Phone �� a -a 01- I In 3`i
Fee Simple Title Holder's Name: a Not Applicable
Name
Mailing Address
City State
Zip Phone
Mortgage Company: a Not Applicable
Name
Mailing Address
City State
Zip Phone
Bonding Company: A 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 architecYengineer 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.
�ignatur!2ft "Wh%e . I.e;see
STATE OF FLORIDA
COUNTY OF MARTIN
The fo e'omg iastcument was aclaiowled^ed before me
this�day of �lr� ,20]�by
T rPV \rl;X
(Name of Person Aclm wled
(Signature of Notary Public —State of Florida) '
(Print, Type, or Stamp Commissioned Name of Notary Public)
Personally Known X— OR Produced Identification
Type of Identification Produced
Florida
Expires 03/29/2022
a /1
i
Stgnatute >C nt otor icer
SPATE OF FLORIDA
COUNTY OF MARTIN
The fo omg instrument was acknowledged before me
this day of bra .20-4by
(Marne of Person Ac{mo�-!g) ^ : A
(Signature of Notary Public —States ooffffFlorida)
(Print, Type, or Stamp Commissioned Name of Notary Public)
Personally Known - OR Produced Identification
Type of Identification Produced
My Commission GG 201733
Expires 03/29/2022
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