HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED'FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number: I "11" •Oq"V
O
Building Permit Application IPP
Planning and Development Services 6eGo
Building and Code Regulation Division Fe S<
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Dock/Seawall
PROPOSED[MP.,E30VMENTwLO[FtiT7Cr4V.
Address: 86 AQUA RA DR
Legal Description: WINDMILL VILLAGE BY THE SEA-UNITTWO- BLK A FROM SW COR LOT 17
Property Tax ID q: 4511-811-0018-000-0 Lot No. 17
Site Plan Name: Block No. A
Proiect Name: HORNICK DOCK
Setbacks Front Back: Right Side: Left Side:
CONSTRUCT A 222 SQ FT DOCK AND BOAT LIFT —r4f"C *)'-II
HaamonaiworKcooe errormeu unuerinispermit—ci
0HVAt Gas Tank ❑Gas Piping
11 Electric 0 Plumbing []Sprin
Total Sq. Ft of Construction: pQ
Cost of Construction: $ �900. O c7
klers
a 5_R(u1z1+L° �aerM,-I-
Shutters ❑ Windows/Doors
Generator Roof = Roof pitch
5 Ft. of First Floor: _
Utilities:Sewer O Septic
Building Height:
+ OV1/(VE(:t..
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Name JAMES HORNICK
Name: GON-Ce -0.
Company: TREASURE COAST BARGE, INC
Address: 86 AQUA RA DR
City: JENSEN BEACH State: FL
Zip Code: 34957 Fax:
Phone No. 704-351-1283
Address- 1200 SE CUTOFF ROAD
City: STUART State: FL
Zip Code: 34994 Fax:
Phone No. 772-201-9777
E-Mail: JAHORNICK(aDGMAIL.COM
Fill in fee simple Title Holder an next page (if different
-from-the Owner -listed- above)
E-Mail: JERNER(PBELLSOUTH.NET
State -or -County -License: 20077
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.'
SUPPLEMENTALCONSTftUCTION`'
...,.1. <_ ,.,z >„ .rqe LIEN
L1. AWFINFORM�TION
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a
DESIGNER/ENGINEER: _ Not Applicable
Name: PAUL WELCH, INC
MORTGAGE COMPANY: _
Name:
Not Applicable
Address: 1984 BILTMORE DR #114
Address:
City: PORT ST LUCIE State: FL
Zip: 34982 Phone 2-785-9888
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not
Name:
Applicable
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, 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 aVrt
ted on the jobsite
before the first inspection. If you intend to obtain financing, c u t Ith lender Qtorney befpret
commencing work or recording vour Notice of COmmeA ment. , --, I /
Sign ure of Owner/ essee/Contracto as Agent for Owner
Signature Contras /License Holder If
STATE OF FLORIDA
STATE OF FLORIDA 1
16Ux
COUNTY OFu c� �
S f t
COUNTY OF
t—��l - n
The forgoing instrument was acknowledged before me
The forgoing instrument wa acknowledged before me
this ZS day of /1/ ViV46 2011 by
this le2day of _)&PmVae
v- , 20—q by
Name of perso.pKaking statement
Name of pers making statement
Personally Known OR Produced Identification
Personally Known Zl/ OR Produced Identification
Type of Identificati
Type of Identification
Produced
Produced
;�v*`'"�'••., LUCIA CAISTOFORO
g - _. y
i na re of Not '- -,—.
Signature of Notary ublic-
u c- a e o onda
n
� mission x GG 219263
E��mh,,.�My
GNN
Comm, Expires May 17.2022
,�Mt���A�N-s
mmission No. '•��'d=ptdof Florida
Commission No.
Bonded t(ESOI}Iatlonal Notary Assn.
`-' • • q Commb11lon R FF 991999
+�. •ss My Comm, Expires' -Jun 22, 2020
-.10-1111 NallcnLal
Notary Assn.. ti
REVIEWS
FRONT
ZONING
SUP R R'
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
-COMPLETED—
Rev. 8/2/17