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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPT ED
Date: Permit Number:(/0 ar___ow�
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Bufl ing per-rout Appki tbn
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/Seawall
PROPOSED IMPROVEMENT LOCATION:
Address: 10701 S OCEAN DR 870
Legal Description: VENTURE OUT AT INDIAN RIVER INC LOT 870(OR 3499-434;3878-2993)
Property Tax ID#: 4511 .510-0071-000-5 Lot No.870
Site Plan Name: PFISTER Block No.
Project Name: PFISTER-DOCK
Setbacks Front Back: Right Side: Leff:Side:
[C�FMAILED DESCRIPTION OF VVORIC:
1. FURNISH AND INSTALL 1 PC. 100+A SQ FT DOCK
2. INSTALL 1 PC. BOAT LIFT
CONSTRUCTION INFORMATION:
Adclitionalwor c to be performed un er t is permit--c iec c al a apply;
ElNVAC Gas Tank []Gas Piping Shr.itters �Windows/Doors
I�1 Electric I aJ Plumbing Sprinklers I�1 Generator Roof Roof pitch
Total Sq. Ft of Construction: Sc. Ft.of First Floor:
Cost of Construction:$ '10,300.00 Utilities:0 Sewer El Septic Building Height:
OBI NER/1-ESS,EE: CONTRACTOR:
Name PFISTER,MARCIA tit RONALD Narne: ROBERT WILLIAMS
Address:6325 W MANSFIELD AVE UNIT 221 Company: WILCO CONSTRUCTION INC
City: DENVER State:CO Address: 10751 ORANGE AVE
Zip Code: 80235 Fax:NIA City: FORT PIERCE State:FL
Phone No.303-517-2616 Zip Code: 34945 Fax: 772-460-6929
[-Mail:NIA Phone No. 772-460-6928
Fill in fee shriple Title Holder on next page(if different E-Mail: WILCOINC@BELLSOU T I-LNET
front the Owner listed above) State or County License: SCC131151026 291'15
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: DANIEL PAUL RETHERFORD Name:
Address:1402 HARTMAN RD Address:
City: FORTPIERCE State: FL City: State:
Zip: 34947 Phone: 772-224-9326 Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
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 our Notice of Commencement.
c - -- s
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF �� ,Q .�-� COUNTY OF Lu C -q-,
The f g instr ,met as acnow/ledge before me The forgoing instrument was acknowledged before me
this& ay of !T 20 y thi day o ,20 OD by
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(Name of person acknowledging) (Name of person acknowledging)
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(Signature of Notary ic- fate of Florida) (Signature of Notary Public-State f Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identificati n Produced
Commission Now `— a Commission I��S:�====:= 1)
AWN FIT GE12�Lp j ) ;;.,•:..:� WN FIT2GC z
MY COMMISSION 1!GO 1623�6 f I: �i ',; MY COMMISSION f�GG 162344
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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DATE
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