HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BED JIPLETED FOR APPLICATION TO BE ACCEI
Date: 0 30 l 0� SCANNED Permit Number: A_ I
�pqo BY RECEIVED
® St. Lucie County OCT 3 0 2019
Building Permit Application
Planning and Development Services 9T. 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: _LQ!�\
Legal Description:
Property Tax ID #:
Site Plan Name: I
Project Name: i% i 1 i 6-t,
Setbacks Front Back: �a, Right Side: LeftSide: )h )K
Installation of Gunite Pool; Deck and Equipment
LIHVAC I IGasTank UGasPiping LJShutters
(]Electric Plumbing USprinklers 1:1Generator
Lot No. 0
Block No. IV
QWindows/Doors
D Roof
Total Sq. Ft of Construction: jXCy;.13. SQ. Ft. of First Floor:
�� i
Cost of Construction: $I
_ )tA LIT% Utilities: OSewer OSeptic Building Height:
Name
Name: Terry Wix
�1,
Address: Al D 611cy- Q, OU1 Dll
Company: Pools by Greg, Inc.
_
City: a y IUD State:
Zip Code: �JWQ Fax:
Phone No.1i9L 9q (� Fj �-
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 $2500Aor more, a RECORDED Notice of Commencement is required.
F \/ n�:w �Cl 1
SCANNEu
BY
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
Designer/Architect/Engineer. ❑ Not Applicable
Name VA. Air(S
Mailing Address i D I HcA 2e l 0 0 C7R .
City Fart Qrt r(e Stated
Zip '�,L4-ilia Phone "}�+ a —a 01—Ito 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: ANotApplicable
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 graming 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.
n
c
t aitue."` 6 @r ` enf/ essee
STATE OF FLORIDA
COUNTY OF MARTIN
The foregoing instrument was aclmowledoed before me
this I day of nr+ .20-%by
(Name of Person Aclm wledging)
(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
I4YdJ
Notary Public State of Florida
My Commission GG 201733
Expires 03/29/2022
Srina`ture:o traciot cei gecVotiiar"' J
STATE OF FLORIDA
COUNTY OF MARTIN
The foregoing ins cal was acknowledged before me
thisf net ,20Aby
(Name of Person Ackro !edging)
(Signature of Notary Public orida
(Print, Type, or Stamp Commissioned Name of Notary Public)
Personally Known— OR Produced Identification
Type of Identification Produced
A Thornasina Bowins
My Commission GG 201733
Expires 03/29/2022
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