HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:y k \ 7• Permit Number: A\dy-dGo-A'
K010-1
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
PERMIT APPLICATION FOR: Boat lift/ Dock
PROP,QS`ED ]'MPROVEMENT LOCATI`0'N :.
Address: 10701 S OCEAN DRIVE LOT 874, JENSEN BEACH, FL 34957
Legal Description: VENTURE OUT AT INDIAN RIVER INC LOT 874
RECEIVED
APR 19 2021
P(jrmitti= g Department
St. Lucie County
Residential X
Property Tax ID #: 4511-510-0075-000-3 Lot No.
Sites Plan Name CASTELLANOS Block No.
Prniart Name- CASTELLANOS
Setbacks Front Back: Right Side: Left Side:
,DETAIL+E�D �p�ESCRI�PTION;OF WOR{< ••.� � -
Furnish and Install 1 pc. 220 +/- Sq. Ft. Dock and 2 Boat Lifts
CON-STRUCT16,N IiNFORMATIiNi:
Additional work to be ]-Gas
r orme under t is permit — check_ a apply:
❑HVAC Tank ❑Gas Piping _Shutters ❑ Windows/Doors
❑Electric ❑..Plumbing ❑Sprinklers ❑Generator ❑Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 40l oco
S Ft. of First Floor: _
Utilities:�Sewer ❑Septic
Building Height:
Q:VVNER/LESSEE . , . ;-. ,
CONTRACTOR. ,,:
Name CASTELLAN08, OCTAVIO
Name: ROBERT WILLIAMS
Company: WILCO CONSTRUCTION INC
Address:10701 S OCEAN DRIVE LOT 874
City: JENSEN BEACH State: FL
Zip Code: 34957 Fax: N/A
Address: 10751 ORANGE AVE
City: FORT PIERCE State: FL
Phone No. 786-486-1968
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
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 KKUKUW Notice or Lommencemenr is requrreu.
= I _111__�
SUPPLEMENTAL CONSTRUCTION'LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: DANIEL PAUL RETHERFORD
Address: 1402 HARTMAN RD
City: FORT PIERCE State:
Zip: 34947 Phone: 772-224-9826
FL
MORTGAGE COMPANY: X Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x 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
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.
,I s
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA C'��
COUNTY OF L � COUNTY OF �1
The tforoing instr ent was acknowledge efore me
thisday of 20by
RW-tq- Mvnidn
(Name of person acknowledging)
(Signature of Notary Pu
blic- State of Florida
Personally Known Produced Identification
Type of Identification Produced��
The forgoing instrume t was acknowledged before me
this day of 20 6_ by
W l" t (m
(Name of person acknowledging)
ignature of Notary Public- State of Florida ).
Personally Known OR Produced Identification
Type of Identification Produced
.,PPY1P1Uje`IDAWNFITZGERALu
Commission No I I Commission No.
a. EXPIRES: December 17, 2021
Revised 07/1-5/-2-0 14
DAWN FITZGEMLD
A*COMMISSI , RUG 162346
EXPIRES: December 17, 2021
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS