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HomeMy WebLinkAboutBuilding Permit Application G y ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number:X1 63� 1 RECEIVED MAR 2 3 2017 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: Boat lift PR®P©SE© 1111/IiP�R` UEME(VT L®CATI'®'N I ! {TIT! I' li Address: 919 JACKSON WAY,FT PIERCE, FL 34949 Legal Description: COASTAL COVES UNIT 1-LOT 25(OR 3929-1558) Property Tax ID#: 1423-802-0027-000-9 Lot No.25 Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: �DE�TiAILE'D ®ES:CRIP ®FWORK ,a -- INSTALL BOAT LIFT *ELECTRIC BY OTHERS* L CONSTR�IJCTf,ONIiNF,ORMATI®N ` r t ° I } I;1 F1 f'; g Additionalwork to e nertormed under this permit-check a app y: 0HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors 11 Electric 0 Plumbing []Sprinklers El Generator u Roof Roof pitch Total Sq. Ft of Construction: S Ft.of First Floor: Cost of Construction:$ 6,500.00 Utilities:]Sewer Septic Building Height: ,01NNER%LESSEE `x �! CONTRAFCTOR 't NameEDWIN WORTH Name: JOYS YANCY Address:919 JACKSON WAY Company: SUMMERLINS MARINE CONSTRUCTION City: FT PIERCE State:FL Address: 200 NACO RD Zip Code: 34949 Fax: City: FT PIERCE State:FL Phone No.772-321-7212 Zip Code: 34946 Fax: 772-464-7470 E-Mail:EWORTH1262@GMAIL.COM Phone No. 772-464-6090 Fill in fee simple Title Holder on next page(if different E-Mail: SUMMERLINSMARINECONSTRUCTION@GMAIL.COM from the Owner listed above) State or County License: 24217 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. J v �_�� � �` al ®RMATION �- . . Srg UPPLE11%IENl"AL NSTRUC I j,, AEI,g IN E 3 `4 r t I G i• .1,1 I.;,, a;,ll;., `' 1 . - DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: HIJIDE BOAT SALES Name: Add ress:4050 SELVTIZ RD Address: City: FT PIERCE State: FL City: State: Zip: 34981 Phone: 772-461-4660 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 commepqr)gwor ,orrecQr,dingvour Notice of Commencement. s SignaturZoo ner/ essee/ on ractor as A t for Owner Signat r or of C ntrac License H r STATE RIDA STA OF FLORIDA COUNTY OF ST-.1. COUNTY OF-LUCIE The forgoing instrument w s acknowledged before me The forgoing instrument was acknowledged before me this day of (�OLJ C� 20 ,aby this 23 day of MARCH 20 L by EDWIN WORTH 1 JOY S YANCY (Name of person acknowledging) (Name of person acknowledging) P � (SignatureWf Notary Public-State of Florida) (Signature cQJNotary Public-State of Florida) Personally Known x OR Produced Identification Personally Known x IOR Produced Identification Type of Identification Produced Type of Identification Produced Commis$lon NO. FF91 93 */ HQSTER Commission NO. FF912939 ,; � R P 9ER :r MY COMMISSION#FF912939 1. My COMMISSIOEXPiRESAWUid07)393.0153 7�IG11 Revised 07/15/2 Lf REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS