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Home My WebLink AboutSUBMITTED PAPERSDATE:aAmi iLi I FEES DUE: RECEIPT #: PERMIT #: .•Itj PLANNING & DEVELOPMENT SERVICES DEPARTMENT a BUILDING & CODE REGULATIONS DIVISION 2300 Virginia Avenue Ft. Pierce, FL 34982-5652 Tel. 772-462-1553 APPLICATION FOR ABOVE GROUND POOL PERMIT Office Use Only Sec: Twp: Rng: Zng: Lu Tech: 1. Location /Site Address: 55 d p& E0 VC, 2. Parcel ID Number: ISO, - b I q' 0 I m 0oo _ 1 3. Pool Dimensions: Length *;L Width CO 4. Height of Pool Above Ground Level: 'r (Must be 10 feet from Overhead Power Lines) 5. Setbacks: Front: Back:J Right Side: b 4Left Side: /.�� / 6. Fence: Yes: No: ✓ Fence Permit #: 7. Description of Pool Ladder: 1"I - FraA,e CorAr , 5w',►-,5 )- L ocK 8. Owners In �rmatio 9 Name: r6 7 Zi& A Address: � City: �(�� P1 tP State: Phone: 2 J9 - i Zip: �A 9. Value of Construction: $ d//�� .1 k0.6u Information: FL Reg%CeA4..� County Cert #: Business Name: Phone Number: Please provide a diagram of the pool location on page 2 of this application. OWNER'S AFFIDAVIT: I certify that all of the information contame this ap lication is that in co iance with ll a plicable s re . lating 'onstruction and zoni g Print wner or Contractor/Qualifier Name ignature of Owner or Contractor/Qualie State of Florida, County of S-V.1-%3 C 1-- The foregoing instrument was acknowledged before me this d day of by <.-`Qln, who is personally known to me or has produced 5" ad-' 1� — ' �O �a a 4P ,,ion `=O'µY PUOl'C� Signature of Notax ublic Type of Print Name of Notary's SLCPDSD Rev 06/21/2010 20 l 7 will be done D N—n s " State of Florida 101,6faErB� 2016 yomm. Expires Dec 16, Commissio�E ggg761 gonced Through Nat onal Notary Assn. 1. N ia,6l/ NOTICE TO OWNER: FAILURE TO RECORD NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IlMIPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. This application can be submitted to St. Lucie County Permitting Department at 2300 Virginia Ave., Fort Pierce, FL 34982. All permit applications must be filled out COMPLETELY before submission. No application will be accepted for processing after 4:30 P.M. for assistance in completing this application, please call (772) 462-1553 during regular office hours (8:00 A.M.- 5:00 PAL Monday through Friday). UPON ISSUANCE OF THIS PERMIT, REQUIRED INSPECTIONS CAN BE SCHEDULED BY CALLING: (772) 462-1261. Pool Location Diagram Please show lot size, dimensions and setback distances from property lines to the pool in the space provided below. POOL PLOT PLAN �3 (Show Setbacks) Your Residence �' w :R (Show Lot Dimensions) i Zoo Planning & Development Services Department Building & Code. Regulations Division 2300 Virginia Ave Fort Pierce, FL 34982 772-462-1553 Owner Builder Affidavit — Electrical Contracting DISCLOSURE STATEMENT F.S. 489.503 (6) EXEMPTIONS State law requires electrical contracting to be done by licensed electrical contractors. You have applied for a permit under an exemption to that law. The exemption allows you, as the owner of your property, to act as your own electrical contractor even though you do not have a license. You may install electrical wiring for a farm outbuilding or a single-family or duplex residence. You may install electrical wiring in a commercial building the aggregate construction costs of which are under $75,000. The home or building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease more than one building you have wired yourselfwithin 1 year after the construction is complete, the law will presume that you built it for sale or lease, which is a violation ofthis exemption. You may not hire an unlicensed person as your electrical contractor. Your construction shall be done according to building codes and zoning regulations. It is your responsibility to make sure that people employed by you have licenses required by state law and by county or municipal licensing ordinances. Failure to do so may result in a liability for you! To qualify for this exemption under this subsection, an owner must personally appear and sign the building permit application. I hereby acknowledge that I have read and understand the above disclosure statement and that I further understand that any violation of the terms of the owner/builder exemption shall be reported by the Community Developmenirec or to the Florid State Department of Professional Regulation. Signed and acknowledged on this 1r (� day of OWNER/BUILDER SIG STATE OF FLORIDA , COUNTY OF Syr • t-1� �'� C The foregoing instrument was acknowledged before me this 1o�b day of ` , 20 by CO -A , who is personally known to me or has produced S&\ =k&— will' -41�t - 42 as - 0 as identification. Signature of Notary Title: Notary Public SLCPDSD Revised 7/23/2010 QR.0,1, 0, 6%y*-0-5 Print name of Notary Commission Number V- �A. S� 1 St. Lucie County Owner Builder Affidavit -Electrical Contracting DEANNA GIVENS P"°<. % Notary Public - State of Florida ° • ° Dec 16. 2016 ;: ,`� • = My COMM. Expices • °� Commission # EE 85876A 9r �P • h National Notary Assn. owF��,.�•• Bonded Throug Planning & Development Services Department Building & Code Regulations 2300 Virginia Avenue Fort Pierce, Florida 34982 (772)462-1553 - OWNER/BUILDER AFFIDAVIT DISCLOSURE STATEMENT F.S. 489.103 M EXEMPTIONS State law requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that law. The exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must provide direct, on -site supervision of the construction yourself. You may build or improve farm outbuildings, a one -family or two-family residence or a commercial building at a cost of under $75,000.00. The building or residence must be for your own occupancy. It may not be built or substantially improved for sale or lease. If you sell or lease a building you have built or substantially improved your self within one year after the construction is complete, the law will presume that you built or substantially improved it for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person to act as your contractor or to supervise people working on your building; it is your responsibility to make sure that people employed by you have licenses required by state law and by county or municipal licensing ordinances. You may not delegate the responsibility for supervising work to a licensed contractor who is not licensed to perform the work being done. Any person working on your building who is not licensed must work under your direct supervision and must be employed by you, which means that you must deduct F.I.C.A. and withholding tax and provide wor s' compensation for that employee, all as prescribed by law. Your construction must comply with all appli bl s, ordinances, building codes, and zoning regulations. Initial I understand that the building official and inspectors are not there to design or give advice on h t the minimum code. Initial I understand that as an owner -builder that any contract disputes with sub -contractors and I must It led in a civil court with the advice of an attorney. This department will not mitigate any contract disputes. Initial I understand that if I compensate any person or company for work performed they are requ' ed to licensed in this jurisdiction. If for some reason they do not possess a license, I may be responsible and 1' f r e cost of the license. Initial I understand that if any person that is unlicensed and uninsured gets injured on my constructi probe they may be entitled to workmen's compensation. I could be held liable for. all doctor, lawyer and re e cost, which could include loss of wages during recovery from their injury. Iniia To qualify for this exemption under this subsection, an owner must personally appear and sign the building permit application and initial the above. I hereby acknowledge that I have read and understand the above disclosure statement and that I further understand that any violation of the terms of the owner/builder exemption shall be reported by the Buildi d nigg Departl ent to the Florida S�Department of Professional Regul ' n. Sign d know ged on th' day of r'7/ of 20/ �� STATE OF FLORIDA COUNTY OF_�• 1 d — 1 The oregoing instrument was acknowledged before me this day of , 20_K, by who is personally known to me, or who has produced - aa— as identi c 'o DEANNA GIVENS a v't ,�1Pa� POai''. o �: , Notary Public - State of�Flo D xpires Dee 16.201E ' y �SLi. Print Name Notary Signature of ary Type or of b� , • • _ ', o ' Commission # EE 85876' Title: Notary Public Commission Number > E ;;.; Bonded Through National Nn+- SLCPDSD Revised 07/2212010 SAVE: HESE INSTRUC72ONS DEALER/INSTALLER: GIVE TO HOMEOWNER "EVOLUTION" A -FRAME LADDER FOR RIGID -FRAMED POOLS ONLY ASSEMBLY AND INSTALLATION MANUAL. The Anti -Entrapment Barrier is included in this ladder for the U.S. and Canada only, as required by ANSI/APSP requirements. The Anti -Entrapment Barrier is NOT intended as a substitute for competent adult supervision. If you would like to purchase the barrier, please visit our website at: www.conferladders.com Made in U.S.A. by CONFER plastics inc. ..�V.G HA- Vr/AItiD� OWNER'S MANUAL INSTALLATION, OPERATION, & PARTS Power -Flo MatrigTm Pump Series The Hayward Power -Flo® MatrixTM Pump Series is specifically engineered for the demanding requirements of today's above- ground swimming pools. The advanced design reduces maintenance requirements while providing superior performance. To prevent potential injury and to avoid unnecessary,service calls, read this manual carefully and. completely. - - z.CAUTION — We highly recommend a qualified professional install and service this product. Al WARNING — This manual contains important safety information that must be furnished to the end user of this product. '-FAILURE TO READ AND FOLLOW ALL INSTRUCTIONS COULD RESULT IN SERIOUS INJURY. ulO*Only units equipped with 3' twist -lock cords are UL-listed. SAVE THIS INSTRUCTION MANUAL HAYWARD POOL PRODUCTS Corporate Headquarters: U.S.A: 620 Division Street 1 Hayward Industrial Drive 2935 Sideo Drive 2875 Pomona Blvd. Elizabeth, NJ 07207 Clemmons, NC 27012 Nashville, TN 37204 Pomona, CA 91768 Canada: Europe: 2880 Plymouth Drive Parc Industriel de la plaine de.l'Ain Oakville, Ontario L6H 5R4 A118e des Ch6nes 01150 Saint Vulbas France