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 34981
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Dock/Seawall II
PROPOSED IMPROVEMENT LOCATION:
Address: 9453 S INDIAN RIVER DR
Legal Description:
19/20 36 41 N 100 IFT OF S 951 FTOF GOVT LOT 3 SEC 19
Property Tax ID #: 3519-441-0003-000-8
Site Plan Name:
Proiect Name: SHCRODER DOCK REPAIR
Setbacks Front Back: Right Side: Left Side:
Lot No.3
Block No.
DETAILED DESCRIPTION OF WORK: II
REPLACE AN EXISTING DOCK IN SAME LOCATION. NO ELECTRIC
HVAC LJ Gas Tank
Electric 0 Plumbing
Total Sq. Ft of Construction: liI & r
Cost of Construction: S 4o 0 4 SO
Piping ❑_Shutters 1:1Windows/Doors
nklers 1:1Generator Roof
SFt. of First Floor: _
Utilities: Sewer E]Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name HENRY SCHRODER
Name: a rL 1�1Nh
Address:9453 S INDIAN RIVER DR
Company: i M1 !VL
City: FORT PIERCE State:_
Zip Code: 34982 Fax:
Phone No. 305-815-9828
Address: -10 II I+Wr YnH (Ca
City: TV `" r tau Staten
Zip Code: 3 y Q Fax: f
Phone No.
E-Mail:cranebreath@yahoo com
FII in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail:
State or County License: C & C 150 Z4 S
It value of construction is SZ5W or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
al) Lynn Pellegrino
DESIGNER/ENGINEER: _
Name: PmLmucH
Not Applicable
MORTGAGE COMPANY:
Name:
•Not Applicable
Address: IOU sweILTMORE Sr V 14
Expires 7/25/202
Address:
COUNTER
City: PM STLUME
Zip: 34M Phone: m -rte
State: rl
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _of
Name:
Applicable
BONDING COMPANY:
Name:
Not Applicable
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
commencing work or recording your Notice of Commencement.
Signature
Signature of
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 5� • LUQ 5L COUNTY OF • L uC�
The fo oing instrument was acknowledged before me The forp�ing instrument was acknowledged before me
this day of r 20 cK by this,=7day of rv),N t) 20,20 by
(Name of person acknowledging) (Name of person acknowledging)
(' ature o Notary otary Public- tate o Florida )
Personally Known �R Produced Identification
Type of Identification Produced
(Signa ure of Notary Publi ate of Florid )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No. all Lynn Pellegrino Commission No.
al) Lynn Pellegrino
NOTARY PUBLIC
NOTARY PUBLIC
Revised 07/15/2014 e Commit GG015483
CammM GG015483
t Expires 7/25/2020
Expires 7/25/202
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS