HomeMy WebLinkAboutBuilding Permit Application4WAV*'__ .. A a
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
RECENED
Building Permit Application
DEC, j 91019
Planning and Development Services
Building and Code Regulation Division
Permitting Department
2300 Virginia Avenue, Fort Pierce FL 34982
St. Lucie County
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Dock/Seawall
PROPOSED IMPROVEMENT LOCATION:
Address: 88 AQUA RA DRIVE
Legal Description: WINDMILL VILLAGE -BY THE SEA -UNIT. TWO- BLKA_. _
Property Tax ID #: 4511-811-0018-010-3
Lot No.17
Site Plan Name:
Block No. A
Project Name: SKIDMORE DOCK
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCT A MARGINAL DOCK AND BOAT LIFT$
CONSTRUCTION INFORMATION:
itiona wor to e pertormea under tispermit—check all apply:
OHVAC Gas Tank []Gas Piping _ Shutters
❑ Windows/Doors
R] Electric 0 Plumbing Sprinklers Generator
Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ �� OaO. O Utilities :Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name:
GuA'f'c-�—
Name SHANNON SKIDMORE
Address: 88 AQUA RA DRIVE
Company: TREASURE COAST BARGE, INC
City: JENSEN BEACH State: FL
Address: 1200 SE CUTOFF ROAD
City: STUART
State: FL
Zip Code: 34957 Fax:
Phone No.
Zip Code: 34994
Fax:
E-Mail: TUBING88880_AOL.COM
Phone No. 772-201-9777
Fill in fee simple Title Holder on next page (if different
E-Mail: JERNEROBELLSOUTHAET
State or County License:
20077
from the Owner listed above)
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
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address: 1984 BILTMORE DR #114
Address:
City: PORT ST LUCIE State: FL
Zip: 34982 Phone 772-185-9888
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY:
Name:
_Not 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 and posted on the jobsite
before the first inspection. If you intend to obtain financing, co�q.ylIt with lender orr attorney befpre
commencing work or recording Your Notice of CommenceD3efi#G ///
�—Y7Gt>•r�i7/�G ��h�07NJ /
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contra f or/License Holder
STATE OF FLORID{
STATE OF FLORIDA I o,f
COUNTY OF /y/��i /V
COUNTY OF r �IK I'Y I
0'
The f99�rr 0.(I Instrument was affknowled ed before me
this / J'�ay of J 1010 01 bed, 20 / 9 by
The fo oing inst ent wa ackAowled d efore me
this ay of � IC � 20 - by
5k;
k Uael Cord ia-) 3-C.
�j-�tAIR;pt/ CJM o1_.2
Name of person making statement
Name of perso making statement
V
Personally Known OR Produced Identification C/
Personally Known OR Produced Identification
Type of Ide ification / `
&S �iiiVy/Lf' C�>^
�%%%r°
Type of Identification
Produced
Produced
p
.C,Q,< _
�
(Sig u of Notary Public- State# Florida)
JESSEDOSS
Signature of Notary a, e o qr kISTOFORO
Florida
,nnµ
IselOn#GO 263069
Commission No. • (fir
27.2022
��Fi Notary Puhlit-State of
Commission No. .; commf(( GGG 2t17 2
17, 2022
.„'
Explres September
My Comm. FxPireS May
"0OrF10 ilmdodthmeudginNotorylleniae
Bonded through National Notary Assn.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17