HomeMy WebLinkAboutBuilding Permit Application 2ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED {�
Date: Permit Numbe .
0
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1S53 Fax: (772) 462-1578 Commercial Residential X
I PERMIT APPLICATION FOR: Dock(Seawall III
PROPOSED IMPROVEMENT LOCATION: III
Address: 131858 INDIAN RIVER DR f
Legal Description:
Property Tax ID #:
Site Plan Name: _
ProjectName: _
4509-120-0010-000-6
NORTON DOCK
Setbacks Front Back: Right Side:
Left Side:
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK: III
CONSTRUCT A 1240 SO FT DOCK WITH A 10' X 10' UPLAND DECK AND STAIRWAY ACCESS
incLt,zdl 7,10xti Ie(Cdli� IO'Xcb` Leffl��n�t�'�I �rrn�
CONSTRUCTION INFORMATION: III
❑HVAC L-J Gas Tank []Gas
11 Electric 0 Plumbing 0Spr
Total Sq. Ft of Construction:
Cost of Construction:$% O60
Piping ❑_Shutters ❑Windows/Doors
nklers ElGenerator Roof = Roof pitch
SqI FFtt.I of First Floor:
Utilities. LJSewer 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 Cade: 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 Holder 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 INFORMATION-
DESIGNER/ENGINEER: _ Not Applicable
Name: PAUL WELCH, INC
Address: 1984 BILTMORE DR #114
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
City: PORT ST LUCIE State: FL
Zip: 34982 Phone 72-7 -9888
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
Address:
BONDING COMPANY:
Name:
_Not Applicable
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 ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or an9covenants 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 po d on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender o attorne fore
commencing work or recordine vour Notice of Commencement. /I
v
SI [u Owner/ Lessee/Contractor as Agent for Owner
Si ur o n / i
se Hold
STATE OF FLORIQA�
ST OFF ORIDA
COUNTY OF II 6� �) l
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The forgoing instrument was cknowledged before me
The forgoing instrument was acknowledged before me
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this,j_dayof A.(e.�.rk-
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Name o person making statement
Personally Known OR Produced Identification I/
Personally Known OR Produced Identification
Type of Identification r!\ //
Type of Identification
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8/19/2023
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Rev.8/2/17