HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Iry b—o��d� Permit Number: _00N—
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Building Permit Application°1/0OPp °10
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: -9eeWSeawall
PROPOSED IMPROVEMENT LOCATION:
Address: 10701 S OCEAN DR. LOT 720 JENSEN BEACH
Legal Description: VENTURE OUT - SECTION C LOT 121 (OR 2695-2872)
Property Tax ID #: 4511-805-0121-000-6 Lot No.
Site Plan Name: MATTSON Block No.
Project Name: MATTSON - SW
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: III
REPLACE 35+/- L. FT. OF SEAWALL WITHIN 18 INCHES OF THE EXISTING SEAWALL
CONSTRUCTION INFORMATION:
11HVAC IiGasTank
11 Electric 0 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 20,955.00
aermit — check a apply:
Sas Piping _ Shutters Q Windows/Doors
Sprinklers 11 Generator EIRoof = Roof pitch
S Ft. of First Floor: _
Utilities:Sewer 0 Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name BRUCE MATTSON
Name: ROBERT WILLIAMS
Address:6558 CASABELLA LN
Company: VVILCO CONSTRUCTION INC
City: BOCA RATON State: FL
Zip Code: 33433 Fax: N/A
Phone No.561-716-7901
Address: 10751 ORANGE AVE
City: FORT PIERCE State: FL
Zip Code: 34945 Fax: 772-460-6929
Phone No. 772-460-6928
E-Mail: BHMATTSONCPA@AOL.COM
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 requirea.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: III
Name: DANIEL PAUL RETHERFORD
Address: 1402 HARWAN RD
City: FORTPIERCE State: FL
Zip: 34647 Phone: 772-224-9e26
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
X Not Applicable
MORTGAGE COMPANY: X Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
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 our Notice of Commencement.
S
Signature o Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA 1 I r STATE OF FLORIDA
COUNTY OF � l U rQ .tom COUNTY OF
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(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known s� OR Produced Identification
Type of Identification Produced
Commission
MYCOMMISSION#GG 162346
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(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No. (Seal)
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Revised 07/ ", '_" EXPIRES: December77,2021
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