HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 / Date: Permit Number: I 6 63
Building Permit Application
Planning and Development Services
Building and Code Regulation Division ,
2300 Virginia Avenue, Fort Pierce 'FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1518 Commercial Residential
PERMITTYPE: DOCK
PROPOSED IMPROVENIENT_LOCATION:PELICANkPOINT
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Address:
Property Tax ID #: 3522-700-0000-000-1 OR 3522-700-0001-000-8
Site Plan Name:
Project Name:
Lot No.
Block No.
DETAILED -DESCRIPTION OF WORKi!: I , !:I Ij I I " '' 1;1,1
CONSTRUCT 6' X 400' ACCESS, 8' X 10' TERMINAL PLATFORM WITH 5 FINGER PIERS
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters
_ Electric _ Plumbing _,Sprinklers _ Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cost of Construction: $ 43,008.00 Utilities: _Sewer _Septic
—Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE:
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CONTRACTOR:'
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Name PELICAN POINT WEST HOA INC
Name:JOY S YANCY
Address:1645 PALM BEACH LAKES BLVD STE 1200
Company- SUMMERLINS MARINE CONSTRUCTION, LLC
City: WEST PALM BEACH State: _
Zip Code: 33401 Fax:
Phone No.772-408-7538
Address:200 NACO RD, SUITE C
City: FT. PIERCE State: FL
Zip Code: 34946 Fax: 772-464-7470
Phone No772-464-6090
E-Mail:LISAK@ADVPROPMGT.COM
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail SUMMERLINSMARINECONSTRUCTION@GMAIL.COM
State or County License24217
It value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SURRL-EMENTALCONSTRUCTION LIEN LAW11INFORMATION:
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DESIGNER/ENGINEER: _ Not Applicable
Name: TQOk
MORTGAGE COMPANY: _
Name:
Not Applicable
Address:
Address:
City: State:
Zip: Phone
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _ 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 l 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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Signatur o w er/ L ss a/Co ractoras Agent.for Owner
.
Signature of on ractol Lice se holder
STATE FLORIDA
STATE OF RIDA
COON .OFSTLUCIE
COUNTY OFSTLUCIE
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this tt day of DECEMBER 20_ by
this tt day Of DECEMBER 20— by
JOY S YANCY
JOY S YANCY
Name of person making statement.
Name of,person making statement.
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
l tic State of Florida
(SignatureV Notaryyp tg,{ji�g �o GG330259
(Signature NotaryPublic-Stat
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,)GingerPHesrer
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Commission No. _
GG330259 4 IRa OBI252023
Commission No. Se
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