HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED )
Date: Permit Number: i271RECEIM
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Building Permit Application JUN 14 2021
Planning and Development Services ittmltting Department
Building and Code Regulation Division !§t.,� County
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Boat lift V
"PROPOSED IMPROVEMENT LOCATION:
Address: 133 QUEEN CHRISTINA CT. FORT PIERCE, FL 34949
Legal Description: QUEENS COVE-UNIT 1 -BLK 9 LOT H
Property Tax ID#: 1414-701-0079-000-0 Lot No.
Site Plan Name: JUREWICZ Block No.
Project Name: JUREWICZ
Setbacks Front Back: Right Side: Left Side:
,DETAILED DESCRIPTION_OF'WORK:
ctodc,
-
.CONSTRUCTION INFORMATION:
Additional work to b M
orme under this permit—check a apply:
11HVAC Gas Tank []Gas Piping tn Shutters Q Windows/Doors
11 Electric El Plumbing Sprinklers D Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 58,000.00 Utilities:cn Sewer O Septic Building Height:
-OWNER/LESSEE: "CONTRACTOR":
Name JUREWICZ,MICHAEL&PAULA Name: ROBERT WILLIAMS
Address:133 QUEEN CHRISTINA CT Company: WILCO CONSTRUCTION INC
City: FORT PIERCE State:FL Address: 10751 ORANGE AVE
Zip Code: 34949 Fax:NIA City: FORT PIERCE State:FL
Phone No.203-858-4904 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.
SUPP EMENTAL.CONSTRU.CTION LIEN LAW INFORMATION:,
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: DANIEL PAUL RETHERFORD Name:
Address 1402 HARTMAN RD Address:
City: FORT PIERCE State: FL City: State:
Zip: 34947 Phone: 772-224-9826 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
Commencement must be recorded and posted on the 'obsite
Improvements to your property.A Notice of Co p J
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
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Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA I I STATE OF FLORIDA
COUNTY OF S� �^'��-�- COUNTY OF
The forgoing instru ent was acknowledge before me The forgoing instrument was acknowledged before me
this day of 20by this day of� �(, 20 by
�oc,r� VV �� l�f t� WV
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary ublic-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known��OR Produced identification Personally Known V P OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission Commission No. _
o�n'r;YyB�c DAWN FITZGERALD Y F DAWN F{TZ.GEFt�aLD
xi ?' COMMISSION#GG'162348
EXPIRES:December 17,2021
gUnderwriters EXPIRES:December 17,2021
Revised 0 I J`� Bonded 7hN Notary�Y PO "9'Fed �eP Bonded Thru Notary Public Undetvmters
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS