HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Permit Number:
RECEIVED
Building Permit Application APR 19 20 i
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Boat lift
PQrmittir;g Department
St. Lucie county
Commercial Residential X
PROPOSED IMPR°OV\EENT LOCATfON..
Address: 10701 S OCEAN DRIVE LOT 645, JENSEN BEACH, FL 34957
Legal Description: VENTURE OUT - SECTION C - LOT 46
Property Tax ID #: 4511-805-0046-000-6
Site Plan Name: MELLONE
Project Name: MELLONE -DOCK & BOAT LIFT
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION QF WORK:
FURNISH & INSTALL A 88 +/- SQ. FT DOCK AND A BOAT LIFT
Lot No.
Block No.
CONSTRI.�Cl`ION: IIVLFO.RMATIO.N
f.
AdditionalworKtol3enerformed under tispermit—check
❑HVAC ❑Gas Piping
all
apply:
Shutters
a Windows/Doors
Gas Tank
_
11 Electric 0 Plumbing
Sprinklers
E]Generator
Roof Roof pitch
Total Sq. Ft of Construction:
17,000.00
S�Ftj. of First Floor:
0
Cost of Construction: $
Utilities.
LJ
Sewer
Septic
Building Height:
OWN ER/LESSEE
,
`. CONTRACTOR:.
Name MELLONE, MARK
Name: ROBERT WILLIAMS
Company: WILCO CONSTRUCTION INC
Address: 10701 S OCEAN DR LOT 645
City: JENSEN BEACH State: FL
Address: 10751 ORANGE AVE
Zip Code: 34957 Fax. NIA
City: FORT PIERCE State: FL
Phone No. 561-543-1196
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.
5IM
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: x Not Applicable
Name: DANIEL PALIL RETHERFORD
Name:
Address: 1402 HARTMAN RD
Address:
City: FORT PIERCE State: FL
Zip: 34947 phone: 772-224-9826
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
commencine work or recording vour Notice of Commencement.
s
Signature of Owner/Lessee/Contractor as Agent for Owner Signature4of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDt�s
COUNTY OF 1�I I I , COUNTY OF TT
The for oing instrume t was ac cnowledged efore me
this day of 20 by
r-Zb_bi+ � ['V10 %
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally
Type of Idi
Commission N
Revised 07/15/2014
ced DAWN Fn
My COMMW7 2021
CXPIP.ES: Decer1e p_�derwRiters
�Rt,.A1ntaN �{{ tYn
The fo/r�,oing instr ment was acknowledged efore me
thiay of Ir' �
s � M20 by
i foer�- W
(Name of person acknowledging)
na� C&�
(Signature of Notary Public- State of Florida )
Personally Known V OR Produced Identificati
Type of Identificati
N 4' GG 162348
Commission No. _= ':.- N1Y COMMIS 1
M : Y-EXPIRES: D Rr Af 17, 2021
Bonded Thni Plotary Public Underwriters
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS