HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: A'. Permit j Permit Number:
RECVe
• `� Building
SCANNED Permit Applicati n NOV 14 2019
Planning and Development Services ST. Lucie County, permitting
Building and Code Regulation Division BY
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie Count
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMITTYPE: RESIDENTIAL SWIMMING POOL
PROPOSED IMPROVEMENT LOCATION -:_ -' >,j.5 r
Address: 131 V6S4j 5,s3vn;,-j
Property Tax ID #: Lot No.
Site Plan Name:P �t Block No.
Project Name:
DETAILED DESCRIPTION OF WORK: ..- Zl-""'
S � � vt�►y'l_ Z.._ _
CONSTRUCTION INFORMATION: -
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ .+} , Z'-/� Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR: -
Name -
A.
Name: BARRY MILLS
Address: f
Company: CRYSTAL POOLS
City: C-4- stV1,ex— State:_
Zip Code: Fax:
Phone No.
Address: 4680 US1
City: VERO BEACH State: FL
Zip Code: 32967 Fax: 772-770-5961
Phone No 772-567-3067
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Maillimmyr@crystalpoolsirc.com
State or County License cpc 1457120
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION'LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
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 ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or anNcovenants 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of ntractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF�52— _ULI-Fi
COUNTY OF L UCLA
The fpfg c instru ent'was acknowledged efore me
this day of t 20 y
The fn 11oin nstr ent was acknowledg beforebme
this .1 da of t 20 b
Name of person making state t.
Name of person making state ent.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Ident at n
Produced
Produced
,.irr:�"•, JAMESROUAN
MYCOMMISSIONq G0008627
AM
J ES ROUAN
MY ,
(Signature Notary Pb jG+St f F�ollt�� ; ........... undsnm:ers
(Signatur f Notary P3plit:;= { o&FI,&idtl F): Novembzr4, 2020
'
.�._ ed 1fm"0127 Pubb'c Undsrn%
Commissi n No. (Seal)
Commis on No.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19