HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
•
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) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Dock
PROPOSED IMPROVEMENT LOCATION:
Add48 AQUA RA DR. JENSEN BEACH
ress:
Legal Description: WINDMILL VILLAGE BY THE SEA -UNIT TWO- BLK A W 1/2 LOT 7
Property Tax ID #: 4511-811-0008-100-8
Site Plan Name: LATHAM
Project Name: LATHAM -DOCK
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Block No.
1. REMOVE &REPLACE EXISTING DOCK W/ANEW 385 SQ FT DOCK &PILES
CONSTRUCTION INFORMATION:
AWL
ional workto be ertormed under this permit—cnecK all apply:
�HVAC Gas Tank ❑Gas Piping _ Shutters Windows/Doors
Electric ❑ Plumbing Sprinklers El Generator Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 16,475.00
S Ft. of First Floor: _
Utilities:Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name WILLIAM & STACIE LATHAM
Name: ROBERT WILLIAMS
Address: 364 NE ELM TER.
Company: WILCO CONSTRUCTION INC
City: JENSEN BEACH State: FL
Zip Code: 34957 Fax: N/A
Phone No. 772-370-5977
Address: 10751 ORANGE AVE
City: FORT PIERCE State: FL
Zip Code: 34945 Fax: 772460-6929
Phone No. 772460-6928
E-Mail: N/A
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 29115
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION
LIEN LAW
INFORMATION:
DESIGNER/ENGINEER: _ Not
Name: DANIELPAULRETHERFORD
Applicable
MORTGAGE COMPANY:
Name:
X Not Applicable
Address: 1402 HARTMAN RD
Address:
City:
Zip: Phone:
State:
City: FORT PIERCE State: FL
Zip: 34947 Phone: 772-224-9826
FEE SIMPLE TITLE HOLDER: X Not
Name:
Applicable
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
commencing work or recording vour Notice of Commencement.
Signature of
s a A� u F VIC
COU1�1`D Y OF
Owner
The f going instr ment was acknowledge fore me
this � day of 20 y
(Name of person
(Signature of Notary1Publ/ic- State of Florida )
Personally Known v OR Produced Identification
Type of Identification Produced
Commission No. e,--=:.,.
Revised 07/15/20
;A� MY COMMfSSION # GG 962348
Bonded Thru Notary Public Underwriters
STATE OF FLORIDA r � I ,,, �/
COUNTY OF �I
The forgoing instru nt was acknowledged before me
this � day of � 20 �by
(Name of person acknowledging )
(Signature of Notary P'ubl/ic- StatA of Florida )
Personally Known V OR Produced Identification
Type of Identification Produced
Commission No.
- �� 1• . '.� -= MY CGMM SSION # GG 162346
Bonded Thru Notary Public Underwriters
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS