HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICA LE INFO MUST BE COMPLETED FOR APPLICATION
TO BE ACCEPTED 2103-0400
Date: Z ZO
Permit Number:
ail AP
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 4624553 Fax: (772) 462-1578 Commercial
� ICSiden':ial X
PERMIT APPLICATION FOR: DOCK / BOAT LIFT
PROPOSED IMPROVEMENT LOCATION:
Address: 1253 NETTLES BLVD, JENSEN BEACH, FL 34957
Legal Description: NETTLES ISLAND INC, A CONDO -SECTION
II PARCEL 1253 AND PRORA T A SHARE IN COMMON
ELEMENTS
Property Tax ID #: 4502=501A440-000-4
Lot No._ _
Site Plan Name: GRECO
Blocic No.
Project Name: GRECO - DOCK / BOAT LIFT
_ �-
Setbacks Front Back: Right Side:
Left Side.
DETAILED DESCRIPTION OF WORK:
1. FURNISH AND INSTALL 1 PC.
344 +/- SQ FT DOCK
2, INSTALL 1 PC. BOAT LIFT
I IcUCTION INFORMATION:
A itiona work to ba erlormed under t is permit— c ec < a app y:
TIVAC Gas Tank ❑Gas Piping _ Shutters Windows/Doors
LlElectric Plumbing Sprinklers
1:1Generator L1 Roof Roof pitch
Total Sq. Ft of Construction:
S Ft. of First Floor:
Cost of Construction: $ 1%500.00 Utilities: Sewer Septic Building Height:
OWNED/LESSEE:
CONTRACTOR:
Name GRECO, PATRICIA
Name: ROBERT WILLIAMS
Company: WILCO CONSTRUCTION INC
Address; 935 NETTLES BLVD
City: JENSEN BEACH State: FL
Zip Code: 34957 Fax: N/A
Phone No. N/A
10751 ORANGE AVE
City: FORT PIERCE State: FL
Zip Code: 34945 Fax: 772460-6929
E-Mail: N/A
Phone No. 772460-6928
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: WILCOINC@BELLSOUTH.NET
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
Name; DANIELPAULRETHERFORD
Address: 1402 HARTMAN RD
City; FORT PIERCE
Zip: 34947
"one: 772-224-9a2s
FEE SIMPLE TITLE HOLDER
Name:
Address:
Citv:
Zip: Phone: _
State: FL
X Not Applicable
MORTGAGE COMPANY:
Name:
Address:
city:
Zip: Phone:
x Not Applicable
BONDING COMPANY: _Not Applicable
Name: _
Address:
City:_
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 jobsne
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.
o .1
400
.1
s
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA
The
forgoing inst nt was acknowledged efore me
thi�� day of 20�by
ame of person acknowledging)
No...1144
(Signature of Notary Public- State of Florida )
Personally Known V OR Produced Identification
Type of Identification Produced
Commission
P"'�'•: DA�$�pfiIjZGERALD
MY COMMISSION # GG 162348
Bonded Thnr Notary public Underwriters
Revised 07/15/2
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this 1� day of
(Name of person acknowledging )
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No.
DAWN FIl•ZGERALD
EXPIRES: December 17, 2021
Bonded Thru tiotary Public Underwriters
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DATE
COMPLETE
INITIALS