HomeMy WebLinkAboutBuilding Permit Application 9'
ALL APPLICABLE- , FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED T
Date: 1 ��15 7 Permit Number:SIro
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�_. RECEIVED
ui ding Permit Applicat on 40
Planning and Development Services 1 OCT 2017
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Building and Code Regulation Division PERMITTING
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2300 Virginia Avenue,Fort Pierce FL 34982 � (�j St. Lucie County, FL
Phone: (772)462-1553 Fax: (772)462-1578 CO mel�cN I Residential X
PERMIT APPLICATION FOR: Boat lift
PROPOSED IMPROVEMENT LOCATION:
Address: 10701 S OCEAN DR 921
Legal Description: VENTURE OUT AT INDIAN RIVER INC LOT 921 (OR 3485-2851)
Property Tax ID#: 4511-510-0121-000-1 Lot No.921
Site Plan Name: FLOYD Block No.
Project Name: FLOYD
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etbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
FURNISH AND INSTALL 1 PC 30,000 LB CAPACITY BOAT LIFT BY HI TIDE
CONSTRUCTION INFORMATION:.
Additional work to be performed un er t is permit—check all apply:
E1HVAC Gas Tank Gas Piping _Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ Utilities: _Sewer D Septic Building Height:
25,000.00
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OWNER/LESSEE: CONTRACTOR:
Name WILLIAM&DIANE FLOYD Name: ROBERT WILLIAMS
Address:10701 S OCEAN DR. #921 Company: WILCO CONSTRUCTION INC
City: JENSEN BEACH State:FL Address: 10751 ORANGE AVE
IZip Code: 34957 Fax.N/A City: FORT PIERCE State:FL
Phone No.772-349-0479 Zip Code: 34945 Fax: 772-460-6929
E-Mail:fdidee123@aol.com Phone No. 772-460-6928
Fill in fee simple Title Holder on next page(if different E-Mail: WILCOINC@BELLSOUTH.NET
from the Owner listed above) State or County License: SCC131151026 29115
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTALCONSTRUCTION LIEN LAW INFORMATION:,
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: DANIEL PAUL RETHERFORD Name:
Address:1402 HARTMAN RD Address:
City: FORT PIERCE State: FL City: State:
Zip: 34947 Phone: 772-224-9826 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,
ai cessory 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
c ommencing work or recording our Notice of Commencement.
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Signature of 0 er Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA IIn , STATE OF FLORIDA 1
COUNTY OF COUNTY OF l
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he forgoing instrument was acknowledged before me The forgoing instrume t was acknowledge before me
this day of 20 lby this�C�iay of 20 by
(Name of person acknowledging) (Name of person acknowledging)
pu"& ]:::v a 4-1--
(Signature of Notary Public-State of Florida) (Signature of Notary Publi -State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
(Commission No. Commission No.
ppW FI BALD MY COMMISSION#FF 077529
MY COMMISSION H FF 077529 -?, EXPIRES:December 17,2017
17.
S s.• r:Q, Bonded Thru Notary Public Underwriters
Revised 07/15/20u4 �;Y
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
JDATE
COMPLETEI citOl
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