HomeMy WebLinkAboutBuilding Permit Application beo r%A , P1eqC50__ r- -
ALI,..A?PLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED l
[date: Permit Number:
20 1 7024g
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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: To Select from dropbox, click arrow at the end of line
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Address: 420 Oleander Avenue, Port Saint Lucie FL 34952
Legal Description: River Park-Unit 2 BLK 18 Lot 5(Map 34/22N) (OR 3660-515)
Property Tax ID#: 3419-510-0220-000-9 Lot No. 5
Site Plan Name: Block No. 18
Project Name: Levy Dock
Setbacks Front Back: Right Side: Left Side:
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construct 10`x2lY Dock RECEIVED
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Additional work o be performed under.this permit-c ec all apply:
OHVAC rl Gas Tank ❑Gas Piping _Shutters Windows/Doors
0 Electric 0 Plumbing OSprinklers O Generator Roof
Total Sq. Ft of Construction: 2490 S . Ft.of First Floor:
Cost of Construction:$ -11Q60.00 Utilities: 11_Sewer E]Septic Building Height:
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Name warren&Flora Levy Name: Dale Gasparik
Address: 420 Oleander Avenue Company: LD Contracting
City: Port St Lucie State:FL Address: 486 High Point Court
Zip Code: 34952 Fax: City: Melbourne State: FL
Phone No. (772)924-7244 Zip Code: 32901 Fax:
E-Mail: Phone No. (772) 924-7244
Fill in fee simple Title Holder on next page(if different E-Mail: reginahellberg@gmail.com j
from the Owner listed above) j State or County License: CBC059269
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If value of construction is$2500 or more,a RECORDED Notice of commencement Is required.
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Paul Welch Name:
Address: 1984 SW Biltmore street Address:
City: Port St Lucie State: FL City: State:
Zip: 349M Phone: (772)785.98BB Zip: Phone:
FEE SIMPLE TITLE HOLDER: _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
com"ncing work or recording our Notice of Commencement.
.721 s
_Signature of Owner/ ssee/Agent Signature of Con ractor/License Holder
STATE OFF__L l� COUNTY OFSTATE OF O ��(, a':
� COUNTY OF JJ��
The for lWng JnstrpMent was acknowledged before me The forgo'ng instr en was acknowledged before me
this ay of c 20/�by this ay of c 20 f2 by
(Na a rson ackn ledging) (Nam o ers n ow dging)
gn t o ot
{ ary Pu i;State of Florida) {Slgna r Notary Publi ate of Florida)
Personally Know ".1,141113ODdt, Personally Known' NCO 6dUefi'
Type of Identificat o �r cel�ia`u state of Florida
Type of Identific is 11�f� ucWtary Public State�f Flnrirl YP ►T, n
' f y co Nellberg qc y Camr!ssion D99 712
,x r�=.�Q My Commission,p�gg 71 Z
Commission No.`s r,oP Frr,i—.nr,25/21 aJf Commission No. '` r'ar,,rr Fxr:sre.5t;5125r2f�&eat
Revised 07/15/2014 �] ® ��" ( �O,
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE `
COMPLETE
INITIALS