HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: \a,�-\\ �.kd\ Permit Number: �R�e1-load
"61 c ft =RECEIVEDBuilding Permit ApplicationPlanning 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: DocWSeavaafF-
I PROPOSED IMPROVEMENT LOCATION:
Address: 119 QUEEN ELIZABETH CT
Legal Description: QUEENS COVE - UNIT 1 BLK 8 LOT J (OR 3699-930)
Property Tax ID #: 1414-701-0071-000-4
Site Plan Name: SCHNEIDER
Project Name: SCHNEIDER -DOCK
Setbacks
Back: Right Side: Left Side:
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK: III
REPAIR / REPLACE EXISTING 91 SQ. FT. DOCK IN THE SAME LOCATION / FOOTPRINT
CONSTRUCTION INFORMATION: III
HVAC I IGasTank
Electric El Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 5,786.00
Piping U Shutters ❑Windows/Doors
nklers 11 Generator Roof Roof pitch
_ S Ft. of First Floor:
Utilities:Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name SCHNEIDER,RICHARD
Name: ROBERTWILLIAMS
Address:119 QUEEN ELIZABETH CT
Company: WILCO CONSTRUCTION INC
City: FORT PIERCE State: FL
Zip Code: 34949 Fax: NIA
Phone No.561-310-3033
Address: 10751 ORANGE AVE
City: FORT PIERCE State: FL
Zip Code: 34945 Fax: 772-460-6929
Phone No. 772-460-6928
E-Mail: NIA
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 29116
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: DANIEL PAUL RETHERFORD
MORTGAGE COMPANY:
Name:
x Not Applicable
Address: 1402 HARTMAN RD
Address:
City: FORTPIERCE State: FL
Zip: 34947 Phone: 772-224-9e26
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
BONDING COMPANY:
Name:
_Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
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
commencine work or rensrdine vour Notice of Commencement.
r
s
nt for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF UI L P f IlJ COUNTY OF cst �,(((_0 a
The for oing ins ment was acknowledged before me
this :9 day of i 20 Lby
A- u.i►i�I a(as
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known V�OR Produced Identification
Type of Identification Produced
Revised
MY COMMISSION # GG 162348
Under*Tffes
The forgoing instrument was acknowledged before me
this '175 day ol` )C 1LYYJYC 20 A by
Rcbr-- vu iOMA
(Name of person J/aaccknno�wledging )
U /l�X-C-�tXA'/✓
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
My COMMISSION # GG 162348
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INITIALS