HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE 1PLEYED FOR APPLICATION TO BE ACCEI
Date: Permit Number:
RECEIVEr)
Building Permit A�+p_�+pANNEDon NOV
Planning and Development Services SC 0 S 2019
Building Lucie County,
2300Virginia Avenue, Fort Pierce FL 34982 St. LucieCounty permitting
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Pool inground
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w„xi� sue" may+. , "1rr 4 -'r , f cM � •xvz��3a 2,y, � , �. '+,� �.�x i £✓ �.,,y`�* e INS.,
RHO sO f®!. PROVEIVI-EN7 LO a ON m = �.�,., 1,100 :
Address: 56l� 1-I 5DYu p W _
ej Unit Bq I =-- _I
Legal Description: JYOdl .tit �VP,{l��
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PropertyTax lD #: b4D2
�EII 11
tob u J�l� ' dbn" 1 Lot No. IWI_
Site Plan Name:
I, Qy d a Block No. Z—
Project Name: LG
nd Y Jr
Setbacks Front�Back: Right Side: .2)(0'— Left Side:
Installation of Gunite Pool, Deck and Equipment
40NSTf CF Q 1 kt TRIM �, �ATI4N %r,. '
.� .:� .�i��4Xn.. aS ;.
ubormY,Ge
r tuna Wor to e- e
un derthis perm it cneCK a 11 apply:
0HVAC GasTank []Gas Piping ❑Windows/Doors
_Shutters
ZElectric PI Bing Sprinklers Generator Roof
'p wo
.
Total Sq. Ft of Construction: S Ft. of First Floor:
d nSeptic Building Height:
Cast of Construction: $ Utilities:Sewer
CibuL_a ��z �y
RROi" 2
N,90 O
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Name Name: Tarrywa
Address: rJJ I Company: Pools by Greg, Inc.
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City: a p lWP State: J�L Address: 8886 S Federal Hwy
Zip Code:'( aqW� Fax: City: Port St Lucie State: FL
Phone No.��9��• VbkD1�JID Zip Code: 34952 Fax: T72-337-9287
E-Mail: Phone No. 772-337-9713
Fill in fee simple Title Holder on next page (if different E-Mail: office@poolsbygreginc.com
from the Owner listed above) State or County License: CPC1458338
If value of constructiorrii ls; $2500 or more, a RECORDED Noti a of commencement is required.
1. - -
gC-ZIrr LEIVIFNl AL CONSTRUCTION LIEN�IA�W�INFO.RM�A'�TIQIV
' �— s,�f�k - r M -� 4` 5 " ''-'
psi£eIM
DESIGNER/ENGINEER: _ Not Applicable
N a me: M. RANDALL ROGERS
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address: 1801 HAMWOOD DRIVE
Address:
City: FORTPIERCE State: FL
Zip: M82 Phone772-2or-te74
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY:
Name:
_Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recor$h9R your Notice of Commencement.
Signature of onLessee/Con for as Agent for Owner
Signature of Con ra for Icense H ler
C USTATE OF NTYOFORIDA
�� lUClf�
ORIDA
1�C1PJ
COUNTY OF
The fo oing instrument was acknowledged before me
thisdayof NMIL IltY by
The forgoing instrument was acknowledged before me
this day by
.20A
_15_ ofND\}MI0-L✓ .20A
TERRY WIX
TERRY WIX
Name of person making statement.
Name of person making statement.
Personally Known 2�0_ OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Producedall A
-.rggrqq..��,,,,�
to de
Notary Public State of Flclioa
Sabrina M Arrington
Notary Public -rate or Fe
,,,� Sabrina M Arrington
....
+� �' Expires mpgn�o23 90a7/B
(Signaturf of Notary Publi
.CamwiaagaGC.Go=
(Signatur o otary Public- Sta daf�upira�=02'2a
Commission No. (Seal)
Commission No- q aq (Seal) �-
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