HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ^ 1
Date: 2 W
Permit Number: a 2J—y �3 1
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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: Boat lift t 010CAv—
PROPOSED IMPROVEMENT LOCATION:
Address: 107018 OCEAN DR LOT 888, JENSEN BEACH, FL
Legal Description: VENTURE OUT AT INDIAN RIVER INC. LOT 888
Property Tax ID #: 4511-510-0089-000-4 Lot No.
Site Plan Name: DIPETRILLO Block No.
Project Name: DIPETRILLO - DOCK & LIFT
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTIONOF WORK:
1. FURNISH AND INSTALL UP TO 148 SQ FT DOCK
2. FURNISH AND INSTALL A NEW BOAT LIFT
CONSTRUCTION 'INFORMATION:
Additional work to be Dertormed under this permit —check all that aDD v:
11HVAC LJ Gas Tank
F]Electric 0 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 22,000.00
UGas Piping
Sprinklers
H-Shutters Q Windows/Doors
F]Generator F]Roof Roof pitch
S Ft. of First Floor:
Utilities: Sewer 0Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name WILLIAM DIPETRILLO
Name: ROBERT WILLIAMS
Company: WILCO CONSTRUCTION INC
Address: 10701 S. OCEAN DR LOT 888
City: JENSEN BEACH State: FL
Address: 10751 ORANGE AVE
City: FORT PIERCE State: FL
Zip Code: 34967 Fax:
Phone No. 954-254-8119
Zip Code: 34945 Fax: 772-460-6929
E-Mail: NIA
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.
`SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: DANIEL PAUL RETHERFORD
MORTGAGE COMPANY: x Not Applicable
Name:
Address: 1402 HARTMAN RD
Address:
City: FORTPIERCE State: FL
Zip: 34947 Phone: 772-224-9826
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
Address:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
City:
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
commencing work or recording your Notice of Commencement.
0
Signature of Owner essee/Contractor as Agent for Owner
STATE OF FLORIDA f
COUNTY OF
The fo going instr t was acknowledg before me
this AXday of 20�by
P)o6eg- W
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known V OR Produced Identification
Type of Identification Produced
Commission N
MY COMMISSION # GG 162348
a`: EXPIRES: December 17, 2021
°P ` Bonded Thru Nota Public
Revised 07/h""Z81��� ry Undervmters
0
S
Signature of Contractor/License Holder
STATE OF FLORIDA �� ����
COUNTY OF
The for wng instru t was cknowledged Pefore me
this ay of 20 by
&2& vu,I 1�ms
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
DAWN FITZGERALD
EXPIRES: December 17, 2021
Bonded Thru Notary Public Undervrriters
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