HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: tea• �'° Permit Number: 's 7Z>Z�
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Building Permit Application
Planning and Development Services MAY 2 2 2015
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 above ground
PROPOSED IMPROVEMENT LOCATION
Address: 1801 Hazelwood Drive
Legal Description. Estates of Longwood Lot 24
Property Tax ID#: 2433-502-0024-000-1 Lot No.24
Site Plan Name: Rodgers Res. Block No. N/A
Project Name: Pool
Setbacks Front - Back: 65' Right Side: - Left Side: 34'
DETAILED DESCRIPTION OF WORK
a
Installation of an above ground pool . 14@r9kfi I's 52'; "Aller detaeh0b4a.
CONSTRUCTION INFORMATION
Additional work to e_e ormee under this permit—check_ a _appy;-:
❑HVAC be
Tank E]Gas Piping Shutters
•-
❑Windows/Doors �
11 Electric ❑ Plumbing ❑Sprinklers ❑Generator ❑ Roof
Total Sq. Ft of Construction: 380 S Ft.of First Floor:
Cost of Construction:$ 250.00 Utilities:In Sewer Septic Building Height:
ODUNER/LESSEE:Owner CONTRACTOR:N/A
Name Marvin Rodgers Name:
Address: 1801 Hazelwood Drive Company:
City: Fort Pierce State:FL Address:
Zip Code: 34982 Fax: City: State:
Phone No.772/201-1634 Zip Code: Fax:
E-Mail:kxfox@hotmail.com Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW.INFORMATION.
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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
commoncing work or recording our Notice of Commencement.
s
_Signature of Owner Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA // u��� STATE OF FLORIDA
COUNTY OF S r LCOUNTY OF
The foE@ oing instrumgnt was acknowledged before me The forgoing instrument was acknowledged before me
,/
this�day of A4 20 15by this_day of 20 by
AI E 1�126- SH t—rt f co
(Name of person acknowledging) (Name of person acknowledging)
'� P��lGLL �• �f✓�C�
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known ce Personally Known OR Produced Identification
Type of Identification ProIF FF.88d Type of Identification Produced
EXPIRES:November 2,2018
Commission No. eo=Notary Public Underwriters Commission No. (Seal)
Revised 07/15/2014Q '
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