HomeMy WebLinkAboutBuilding permit app All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: O `�1' 2(JZt7 Permit Number: ...c +0_�0_
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential. X
2300 Virginia Avenue,Fort Pierce Ft 34982
Phone:(772)462-1553 Fax:(772)462-1578
`:PERMIT APPLICATION FOR:DOCK
PROPOSED IMPROVEMENT LOCATICEN w.
Address: 4249 S INDIAN RIVER DR, FT PIERCE, FL 34982
Property Tax ID#: 2435-141-0002-000-0 Lot No,
Site Plan Name:. _ Block No.
Project Name:
QETAILED DES CRIPTION OF WORK: x
v ..
REPLACE DOCK
New Electrical Meter Second Electrical Meter.
CONSTRUCTIOWN FORM, ]ON
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors _Pond
_Electric _Plumbing _Sprinklers _Generator —Roof Pitch
Total Sq.Ft of Construction:. Sq.Ft.of First Floor:
Cost of Construction:-$ 31,500.00 Utilities: _Sewer _Septic Building Height:
=OWNER/LESSEE:: ;. CONTRACTORis
Name STEVEN &DANIELLE WOLF Name:JOY S YANCY
Address:4249 S INDIAN RIVER DR Company:SUMMERLINS MARINE CONSTRUCTION
City: FT PIERCE State: Address:200 NACO-RD#C
Zip Code:
34982 Fax: — City:.FT PIERCE State:FL
Phone No.516-779-4723 Zip Code: 34946 Fax: 772-464-7470
I E-Mail:SWOLF19 N.YC.RR.COM. Phone No 7.72464-6090
.COMGMAIL Fill in fee simple Title Holder on next page if different E-Mail SUMMERLINSMARINECONSTRUCTION @. _,
) County 24217
from the Owner listed above State or Coun License
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
If value of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required.
`SUPPLEM ;,
'b ONSTRUCTION LIEN,LAW ENTAL'C INFORMATION;
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name.PAULWELCH ........_ _.. Name:. '
Address:.la—slaBILTMORESTY,1a Addre$s:.,
City: PORT aT Lucie State: City: State:
Zip:M ,: Phone772-785-988a Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
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 Count makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in convict 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 paying twice for
improvements to your property.A Notice of Commencement must be recorded in the public-records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing,consult
with lender or an attorne before commencing:work-or record Ih 'your.Notice of Commencement.
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Siefure of Owner/Less ontractor as Ag: t for Owner Signatuile of ContrSctWLicense moulder
STATE OF FLORI STATE OF FLORIDA
COUNTY OF U Ci -Q COUNTY OF ST.LUCIE
Sn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
7 Physical Presence r Online Notarization X Physical Presence or Online Notarization
this day of ._C)94 2020 by this day of. 0( ;- - 2020 by
JOYS YANCY
Name of person making statement. Name of person making statement. p
Wally Known OR Produced Identification ✓ Personally Known X OR Produced Identification m - .a
�iyp of IdeKntificati,n Type of Identification y; a m
red Produced w 3
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( iY ) (Signature o ota Public-State �="
K ature,o ` ota Public-State of Florida
�,� ( g ry of Florida) "
. �• :isslon NO. "+ - (Seal)' Commission No. GG3302ss (Seal)
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EWS FRONT ZONING SUPERVISOR PLANS VEGETATION 'SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
PAT IC
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DATE::
COMPLETED:
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