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HomeMy WebLinkAboutSUBMITTED PAPERSSCANNED BY St, LuciA County I DATE: I V Zo / 11 I FEES DUE: I S I RECEIPT #: I PERMIT #: i,LL 7- F,)2 Y v I PLANNING & DEVELOPMENT SERVICES DEPARTMENT 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: J? I Twp: 1-36 Rug: "( 1 Zug: Too I Lu Tech: 1. Location /Site Address: q Q43-3 . 1Y10 q 7- C Nl F IC / 2. Parcel ID Number: 3 3 3gT -- v5" 4 f r ®j'Y ,C? - d tin 11 3. Pool Dimensions:Length 9i Width S b J 4. Height of Pool Above Ground Level: 13 .1r:+ 'T !/,3 (Must be 10 feet from Overhead Power Lines) VD I- U t 0 Af .S P qS 5. Setbacks: Front: Back: Right Side: Left Side: 6. Fence: Yes: x No: 5c13��w , N p/trif5 7. Description of Pool Ladder: 8. Owners Information .11 Fence Permit #: rr✓ © .S T ar4p Name: C1 SIB �- Address: gD03 -X110 R-r c:H jp C 1 C City: P b RT s 7 I-y e fjF- State: = L Phone: 't 3 1 5 &d 9 zq1 Zip: 34r-i'96 9. Value of Construction: $ X1-2 AlA" 9. Contractor Information: FL Reg/Cert #: County Cert #: Business Name: Phone Number: Please provide a diagram of the pool location on page 2 of this application. OWNA'S AFFIDAVIT: I certify that all of the information contained in this application is co ect "t work will be done in compliance with all applicable laws regulating construction and zoning. /'/-1 J,09 m e= S C F-I S" &-13 rture L /�Print Owner or Contractor/Qualifier Name ner or ntral r/ ualifier State of Florida, County of 4v t "r t. The foregoing instrument was acknowledged before me this X day of �Q V(eA 1L)f4:< 20 0 by '-A l.� *Ylf }� G [ jgS who is personally known to me or has produced {F,)L • ULQ' _` "L[� 1 �`" as identification. \ ^ \ V �•.a� p`,,� DOROTHY OLEJNIK Signature of o tic}�e of Pr' ame ofN y T i°B`��; Notary��{'c - State of Floj1da • My Comm. �xpires Mar 18, Commission # DD 97244SLCPDSD Rev 06/21/2010 h4iii�' Bonded TAf0* Nations) Notary s� r6M P&-, �,� J� «/Z - o// 3 NOTICE TO OWNER: FAILURE TO RECORD NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR BIPROVEMENTS 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 P.M. 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 (Show Setbacks) J5CR EiU }� (4 l ,l W .a s PON W ¢r�oratJ� 2 Your Residence- �a/K IV (Show Lot Dimensions) PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION BUILDING PERMIT. SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: State of Florida Certification Number (If applicable): b ocNa"E\cc�c�.�tc., have agreed to be the (Co parry Name/Individual Name) sub -contractor for �'Z�,h�e.�S �• ��Shef' (Type of Trade) (Primary Contractor) for the project located at go03 %OiN C,�•e�:�cC�e,'t'oc (Project Street Address or Property Tax ID #) It is understood that, if there is any change of status regarding our participation with the above mentioned project, I will immediately advise the Building' and Zoning Department of St. Lucie County by personally filing a Change of Contractor notice. (Form: SLCCDV No. 004-00) BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License) ORIGINAL SIGNATURES ARE'REQUIRED SIGNATURE 10 PRINT NAME DAT Business Name: Address: �c—Mtv(�. 3Ss " 5E. Noapowy.\Y� . City/State/Zip: S_k�.+MIC4:11 N-: L Phone: email: OFFICE USE ONLY: PERMIT # ISSUE DATE Change of Electrical Contractors Date: March 2, 2012 From: Ker's Electrical Contracting - ER 13014354 To: Dorgan Electric, Inc. - EC 13002303 Permit #: SLC 1112-0206 Job Located at: 9003 Short Chip Circle Port St. Lucie, FL 34986 Owner Builder & Property Owner: James C. Fisher PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: 1i State of Florida Certification Number (If applicable): �� 30 J Vs k r PS Oecfor c4l &f m ao'itng , L C- have, agreed to be the (Company Name/Individual Name) sub -contractor for � ,f, q 5' Sr�/�` (Type of Trade) (Primary Contractor) for the project located at gDo3 . SA40 /a `;;I- 02l114 C (Project Street Address or Property Tax ID #) It is understood that, if there is any change of status regarding our participation with the above mentioned project, I will immediately advise the Building and Zoning Department of St. Lucie County by personally filing a Change of Contractor notice. (Form: SLCCDV No. 004-00) BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License) ORIGINAL SIGNATU S AR UIRED SIG AT PRINT 14AME DATE Business Name: kegs �J�G7 /'� CQ C-i�/� �! QG�in �1 1t.L G Address: ?A / !c City/State/Zip: Or -t- S l"e- Phone: t7.1 -3 a °t — 51:3 g email: I Yw f; �/vt 4i� �✓Iy nFFTCF. TTSW 0NI,Y: v PERMIT # ISSUE DATE PLANNING & DEVELOPMENT SERVICES DIVISION BUILDING & CODE REGULATIONS DIVISION 2300 Virginia Ave Fort Pierce, FL 34982 BUILDING PERMIT SUB -CONTRACTOR SUMMARY C %` / 5 I-/ G' �. will be using the following sub -contractors for the (Company/Individual Name) project located at 2&0 3 C"'?%4 C f (Street address or Property Tax ID #) It is understood that if there is any change of status regarding the participation of any of the sub -contractors listed below, I will immediately advise the Building and Zoning Department of St. Lucie County. Trade Name of Company/Contractor . St. Lucie County/ State of Florida License Number Electrical , r�q �on �< 1 �1�i+ CC Jost 3YV� l o� Plumbing HVAC/ Mechanical Roofing Gas nFiwTriv TTCF. nNT.V- Vl'1"1'V--• —7 PERMIT ISSUE DATE: NUMBER: p— 1'0— WoPlanning & 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 yourself within 1 year after the construction is complete, the law will presume that you built it for sale or lease, which is a violation of this 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 Development Director to the Florida State Department of Professional Regulation. Signed and acknowledged on this ' 2 !? day of Me , 20 P/ OWNER/BUIL4)ER SIGNATURE STATE OF FLORIDA 1. COUNTY OF Q/�,r tA The foregoing instrument was acknowledged before me this day of fixj,')Vt V, � , .20 —Lk, by \ P1t [�1� , who is personally known to me or DOROTHY OLEJNIK ��L. .z,�7 t�" Lj��� �1�1 d r as identificatio `p•PAVP has produced`Bl;-., — ; a , , o ; Notary Public - State of Florida rn �rr =• ' •E My Comm. Expires Mar 18, 2014 �'ozo �ei1 P n, V� .o:= Commission OD 972447 Signature of N tary Print n e Notary �''��°t�� ��� Bonded Through National Notary Assn. Title: Notary Public Commission Number 12 L SLCPDSD Revised 7/23/2010 St. Lucie County Owner Builder Affidavit-Electrical'Contracting PGA VillageTM Property Owners' Association, Inc. December 2; 2011 - - - ---- -James Fisher--- - — - - - - - - - - - - - - -- --- - -=- -- - - - - T --- -- ------ - - 9003 Short Chip Circle _Port St.- Lucie, FL_34986-- -. _ - - -----RE-:- -ISL-AND POINT' --IL- OT-40 - - - - - - -- - --- - -- = - -- - - -- - - ----- - -- - - -- --- --DESCRIPTION:- SCREEN -ENCLOSURE; PA-VER WALKW-AY &-ELECTRIC FOR HOT TUB Mr. Fisher; The PGA Village POA Architectural Review Committee met on December 2, 2011 and unanimously approved the installation of the screen enclosure at the rear patio, paver walkway and electric for the hot tub contingent upon receiving a copy of the Permit from St. Lucie County. Should you have any questions or concerns please feel free to call our office (772) 467-1503. Thank you. Steve B own, LCAM on behalf of PGA Village POA.Architectural Review Committee 2140 NW Reserve Park Trace Port St. Lucie; Florida 34986 (772) 467-1503 (772) 467-0127 fax