HomeMy WebLinkAboutBuilding permit applicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
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: Dock
PROPOSED IMPROVEMENT LOCATION
Address: 10701 S OCEAN DRIVE LOT 715 JENSEN BEACH
Legal Description: VENTURE OUT - SECTION C - LOT 116 (OR 3458-118, 120)
Property Tax ID #: 4511-805-0116-000-8
Site Plan Name: LONG
Project Name: LONG - DOCK & BOAT LIFT
Setbacks Front Back:
Right Side: Left Side:
Lot No. 715
Block No.
I DETAILED DESCRIPTION OF WORK: I
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AnY$ +/_,54 Ft- 11/I0 DQ�t
2. Fu`ni Sh
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8600 LW -
CONSTRUCTION INFORMATION:
Additional work to ff
rorme un er t is permit - c ec a appy:
11 HVAC Gas Tank Gas Piping _ Shutters a Windows/Doors
❑✓ Electric ❑ Plumbing 11 Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 13.O 75.
S. of First Floor: _
Utilities: Sewer 0 Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name: ROBERT WILLIAMS
Address: 914oJ S. Indian Kye/
Company: WILCO CONSTRUCTION INC
City: FOI'-f- State: FL
Zip Code: 34qi? Z Fax: AJ f J'
Phone No. ^ -/ 0-7,54LZip
Address: 10751 ORANGE AVE
City: FORT PIERCE State: FL
Code: 34945 Fax: 772-460-6929
Phone No. 772-460-6928
E -Mail: NIR
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: WILCOINC@BELLSOUTH.NET
State or County License: SCC131151026 29115
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name: DANIEL PAUL RETHERFORD
MORTGAGE COMPANY: X Not Applicable
Name:
Address: 1402 HARTMAN RD
Address:
City: FORT PIERCE State: FL
Zip: 34947 Phone: 772-2249826
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:
BONDING COMPANY: Not Applicable
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
commencine work or recordint; vour Notice of Commencement.
Signature 6f Owner/Lessee/Contractor as Agent for Owner Signature Holder
STATE OF FLORIDA �1 STATE OF FLORIDA �Y
COUNTY OFy1 IC�Q� COUNTY OF
The fprgoing instrumt as acknowledge before me
this _U day of 20 �y
-�vil S
(Mame of person acknowledging)
UL"
(Signature of NotaryPublic-State of Florida
/)
Personally Known OR Produced Identification
Type of Identification Produced
Theforgoing instru ent was acknowledgeb.., me
this � day of 20 by
P"i_ W I 1 ITM
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No. `,S:KYdy� DAW"J ERAL62348D I Commission No.
I '•*. MY COMMISSION R GG 1
rXPIPF.4• nvcvmher 17.2021
Bonded Thru No" Public Underwiters
Revised 07/1
DAWN FITZCERALD
EXPIRES: December 17, 2.021
Bonded Thni Notary Public Underwiters
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