HomeMy WebLinkAboutBuilding Permit ALL APPLICAB E INFO NfJST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: f Permit Number: ��5G_ z/
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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: Dock/Seawall
PROPOSED IMPROVEMENT LOCATION:
Address: 10701 S. OCEAN DRIVE, LOT 876, JENSEN BEACH, FL 34957
Legal Description: VENTURE OUT AT INDIAN RIVER INC. LOT 876
Property Tax ID#: 45151000770007 Lot No.876
Site Plan Name: WELCH Block No.
Project Name: WELCH
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
INSTALL MARGINALI)OCK 180 SQ. FT.
CONSTRUCTION INFORMATION:
Additional work to e e orme un er t is permit—check a apply:
�HVAC E]Gas Tank Gas Piping _Shutters Q Windows/Doors
Electric E] Plumbing Sprinklers Generator F] Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 5,000.00 Utilities:0 Sewer[]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name BARRIE WELCH Name: R.WILLIAMS
Address:7020 RATTALEE LAKE RD. Company: WILCO CONSTRUCTION INC
City: CLARKSTON State:MI Address: 10751 ORANGE AVE
Zip Code: 48348-1826 Fax: City: FORT PIERCE State:FL
Phone No.772-229-2129 Zip Code: 34945 Fax: 772-460-6929
E-Mail:FROSOSKY@AOL.COM Phone No. 772-460-6928
Fill in fee simple Title Holder on next page( if different E-Mail: WILCOINC@COMCAST.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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _ 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: _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
Record Notice of Commencement may result in our paying twice for
WARNING TO OWNER: Your failure to eco d a y y p y g
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.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA I , , STATE OF FLORIDA c
COUNTY OF l.M COUNTY OF
The forgoing instrument was acknowledge acknowledgeq before me The fQlrgcing instru=ents acknowledged before me
thiday of , _ 20by thisay of 20 �by
VV*lt �I � ,1� V�JI 1,0(q
(Name o person acknowledging) (Name of person acknowledging)
D� 0 t taA��
(Signature of Notary Public-State of Florida) (Signature of Notary Public-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.
DAWN FIIZGERALD , ; DP
l qm
ERALD
:.: MY COMMISSION#FF 077529
MY CC�AMISS10N#FF 077529
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•'' Bonded Thru Notary PuN c Underwrde s t� tended Thru Notary Pudic Underwriters
Revised 07/15/2014 f,�;-"_ .:�.'''
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