HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED `
Date: V 207—Permit Number: a 1403-dr4�
RECEIVED
APR 19 1011
Building Permit Application pormltting Department
Planning and Development Services St. Lucie County
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: m.
Address: 43 NETTLES BLVD
Legal Description: NETTLES ISLAND INC, A CONDO -SECTION II PARCEL 43 AND PRORATA SHARE IN COMMON
ELEMENTS
Property Tax ID #: 4502-501-0229-000-2
Site Plan Name: MACLEOD
Project Name: MACLEOD -DOCK
Setbacks Front Back: _
I. DETAILED DESCRIPTION. OF WORK:
Right Side: Left Side:
FURNISH AND INSTALL A MARGINAL DOCK UP TO 160 SQ. FT. +/-
Lot No,
Block No.
CONSTRUCTION INFORMATION:
Additional work to eperformedunder t—checkispermit a apply:
[1HVAC 11 Gas Tank []Gas Piping _ Shutters a Windows/Doors
FlElectric ❑ Plumbing OSprinklers ElGenerator E]Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 16,000.00
S Ft. of First Floor: _
Utilities. —Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name MACLEOD, DONALD & BONITA
Address: 43 NETTLES BLVD
Name: ROBERT WILLIAMS
Company: WILCO CONSTRUCTION INC
City: JENSEN BEACH State: FL
Zip Code: 34957 Fax: NIA
Phone No. 513-478-6365
E-Mail: NIA
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Address: 10751 ORANGE AVE
City: FORT PIERCE State: FL
Zip Code: 34945 Fax: 772-460-6929
Phone No. 772-460-6928
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: DANIEL PAUL RETHERFORD
Address: 1402 HARTMAN RD
City: FORT PIERCE State:
Zip: 34947 Ph on e: 772-224-9826
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
FL
x Not Applicable
MORTGAGE COMPANY: x Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name: _
Address:
City:_
Zip:
I certify that no work or installation has commenced prior to the issuance of a permit.
Phone:
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: Y ur failure to Record a Notice of Commencement may result in your paying twice for
improvements to you r perty. A Notice of Commencement must be recorded and posted on the jobsite
before the first ins cti . If you intend to obtain financing, consult wi der or an attorney before
commencing wor or r ording your Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner I Signature
STATE OF FLORIDA L�I (.Q )
COUNTY OF __
The forgoing inst nt was acknowledg efore me
this ,Wday of 20 by
Poc"(+ VQ i Ot Qm
(Name of person acknowledging)
(Signature of Notary Public- tate of Florida )
Personally Known Ll� OR Produced Identification
Type of Identification Produced - -
Commission No.
Revised 07/15/2014
DAWN FITZGERALD
MY COW990N # GG 162348
EXPIRES: December17,2021
Holder
STATE OF FLORIDA a �
COUNTY OF
The f Ding instrument was acknowledged before me
this day of 6L &� 20,A_ by
Rjne� Iil Al, It' a M s
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No.
DAWN FITZGERALD
: s/j .= MYCOMMIR-OWnr.I41—..
LAFIXES: December 17, 2021
Bonded Thru Notary public Underwriters
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