HomeMy WebLinkAboutPermit App SmithAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: Ioq Permit Number:
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Building Permit Application
Planning and Development Services f
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Replace Dock
PROPOSED IMPROVEMENT LOCATION:10101 South Indian River Drive
Address: 10101 South Indian River Drive Fort Pierce, FI 34949
Property Tax ID#: 3529-231-0007-100-3 Lot No.
Site Plan Name: Dr. Kelly Smith Block No.
Project Name: Dr. Kelly Smith
DETAILED DESCRIPTION OF WORK:
Install 290' x 4' dock and 10'x16' Terminal Platform
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
Mechanical Gas Tank _ Gas Piping _ Shutters _ Windows/Doors J Pond
Electric _ Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction: 1320 Sq. Ft. of First Floor:
Cost of Construction: $ 75,000.00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Dr. Kelly Smith Inc. j Name: Steven Caswell
Address:2045 SE Avon Park Drive Company: Custom Built Marine Construction Inc.
City: Port St. Lucie State: Address:3119 Hammond Rd
Zip Code: 34952 Fax: City: Fort Pierce State: FI
Phone No. Zip Code: 34946 Fax: 772-333-2390
E-Mail: Phone No772-333-2383
Fill in fee simple Title Holder on next page ( if different E-Mail Sabrina@cusombuiltmarine.com
from the Owner listed above) State or County License
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY:
Name:_
Address:
City:
Zip:
Phone
State:
Name:_
Address:
City:
Zip:
Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable ; BONDING COMPANY:
Name:_
Address:
City:
Zip:
Phone:
Name:_
Address:
City:
Zip:
Phone:
Not Applicable
State:
Not Applicable
I
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
,fie County and poste -�n the jobsite before the first inspection. If you intend to obtain financing, consult
with lendenor an attor6ey,before commencing work or recordingy. ur Notice of Commencement.
Signature of Owner/ 6essee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF 'ICI e_
Sworn to (or affirmed) and subscribed before me of
i� Physical Presence or Online Notarization
this D� day of t , 20261 by
Dr Kelly Smith
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
C
(Signature of Notary - 1i *eI�YGQA1AdW)ON#GG163728
_a=. P; EXPIRES: December 8, 2021
Commission NO. — OV BondedR. brk Underwriters
REVIEWS FRONT
COUNTER
DATE
RECEIVED
DATE
COMPLETED
of t-antra-ctor/License
STATE OF FLORIDA
COUNTY OF Saint Lucie
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or Online Notarization
this Q % day of _Apr i 1 , 2020 by
Steven Caswell
Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced 1111M
SABRINABU TER
MY COMMISSION # GG 163728
(Signature of Notary Pui
�b r-t'N%:V�ua-ler—
Commission No. GG163728
ZONING SUPERVISOR I PLANS VEGETATION
REVIEW REVIEW REVIEW REVIEW
Eit&`C]t F�¢itddalahju Notary Public Underwriters
(Seal)
SEA TURTLE MANGROVE
REVIEW REVIEW