HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: FIEUl�
m
DEC 1 4 2015
Building Permit Application PFRE,AITTING
Planning and Development Services st. Lucie county, FL
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: To Select from dropbox, click arrow at the end of line
WOO ' Ty,
Address: 9115 Champions Way Port St Lucie FL 34986-2808
Legal Description: Lakes at PGA Village(PB-43-32) BLK B Lot 4(or 3726-1573)
Property Tax ID#: 3334-501-0082-000-1 Lot No.
Site Plan Name: Block No.
Project Name: Install Portable Hot Tub
Setbacks Front Back: Right Side: Left Side:
I Ell
r,-.OtMvTyl RI ;FIR6
is
Installing a Portable Hot Tub
RddiWitionalo epe "ormed under this permit—c'heCK all that appy:
HVAC 0 Gas Tank ❑Gas Piping _Shutters a Windows/Doors
11 Electric 0 Plumbing Sprinklers 11 Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ ���®. 00 Utilities.
Sewer Septic Building Height:
Name John K&Kathleen Fleming Name: Homeowner Builder
Address:9115 Champions Way Company:
City: Port St Lucie State:FL Address:
Zip Code: 34986-2808 Fax: City: State:
Phone No.203-507-3821 Zip Code: Fax:
E-Mail:jackflem@gmail.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.
NMI
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: ,Not Applicable BONDING COMPANY: 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 thepermit 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 recording our Notice of Commencement.
s
Siure of Owner/Lessee/Age Signature of Contractor/License Holder
STA E OF FLORIDA STATE OF FLORIDA
COUNTY OF :�- Lj.-,c-t COUNTY OF
The forgging instrument was acknowledged before me The forgoing instrument was acknowledged before me
this I Qday of C e m&,\ 201 by this day of 20 by
(Name of person acknowledging) (Name of person acknowledging)
4'e,
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known v"' OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
BRENDA AM LISM
Commission No.FF D`t o-7-7 * aI)MYCOMMISSION#FF 07 Bommission No. (Seal)
EXPIRES:January 25,2 18
Bonded 1hN B Nohry Se es
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS