HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
o �
Buildine Permit Annlication
Planning and Development Services
Bui!%ln- and rode Re,-ulatlon
2300 Virginia Avenue; Fort Pierce FL 34982
Phone: 117721462-1558 Fax: 1772146?-1579, ('pmmPrrial Residential X
PERMIT APPLICATION FOR: Dock/Seawall
PROPOSED IMPROVEMENT LOCATION:
Address: 13185 S INDIAN RIVER DR
Legal Description:
Property Tax ID #: 4509-120-0010-000-6 Lot No.
Site Plan Name: Block No.
Project Name: NORTON DOCK
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCT A 1240 SQ FT DOCK WITH A 10` X 10` UPLAND DECK AND STAIRWAY ACCESS
CONSTRUCTION INFORMATION:
AcIditional work to borme un er t is permit— c ec
a app y:
1]HVAC
nGas
Tank
DGas Piping
Shutters
E]Windows/Doors
17Electric ❑ Plumbing
Sprinklers
0 Generator
LJ Roof Roof pitch
Total Sq. Ft of Construction:
S Ft. of First Floor:
Cost of Construction: $ _70I p6c
Utilities:Sewer
Oseptic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name GUY NORTON
Name: SCOTT SZAFRANSKI
Address: 13185 S INDIAN RIVER DR
Company: HARBOR BAY MARINE INDUSTRIES, INC
City: JENSEN BEACH State: FL
Zip Code: 34957 Fax:
Phone No. 228-342-0270
Address: 1525 SE CAMBRIDE DR
City: PORT ST LUCIE State: FL
Zip Code: 34952 Fax:
Phone No. (772)335-7080
E-Mail: TRINITY.NORTON@GMAIL_COM
Fill in fee simple Title Bolder on next page ( if different
from the Owner listed above)
E-Mail: scott@harborbaymarine.com
State or County License: 18367
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW WFORMA T ION:
DESIGNERJENGINEER: Not Applicable
Name: PAUL WELCH. INC
Address: 1984 BILTMORE DR #114
City: PORT ST LUCIE State: FL
Zip: 34982 Phone 772-785-9888
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
zip: Phone:
FEE SIMPLE TITLE HOLDER: — 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 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, wails, 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 po d on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender o atto rn3eykefore
commencin.g work or recording our Notice of Commencement.
Si to Owner/ Lessee/Contractor as Agent for Owner
Sig ur o n ac / ' se Hold
STATE OF FLORI A j
COUNTY of ice t 1 vim'
ST OFF ORIDA
C uNTY OF
The forgoing instrument was cknowledged.before me
this ' ay of s C_ 20�U by
The forgoing instrument was acknowledged before me
this �\ day of ILA a„,r i'-- 20 X by
lDST
S S2CT(641S14;
Name o person making statement
Personally Known OR Produced Identification E/
� ,
Name of person m ing statement /
Personally Known OR Produced Identification
Type of Identification `�
Produced�� �1�, t1P�S �< t _
Type of Identification
Prod iaT�,MrS�
(Signat6e14Notary Public- State of Florida }
�,ttAYPUo�, 3):SSI=U05S
Commission No. eal};ommisslon#GG2$3
�y< Expires September 27,
forf BondodThruBudgatNoterySe
Aw
OIdRlt�iIINE R. PACHECO
NOTARY PUBLIC
commission No.STATi �DRI�LORIDA
e of No:�W!Explres
22 Comm# GG367482
Icoe 8/19/2023
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17