HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / 1A
Date: Permit Number: Z `' l b � — ., S 3
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Building Permit Application 1101 C 0 d3S
Planning and Development Services Q3AI3332i
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: Boat lift
PROPOSED IMPROVEMENT LOCATION:
Address: 43 SOVEREIGN WAY, FORT PIERCE, FL 34949
Legal Description: QUEENS COVE - UNIT 1 - BLK 4 LOT A
Property Tax ID #: 1414-701-0029-000-5
Site Plan Name: GIJANTO
Project Name: GIJANTO - BOAT LIFT
Setbacks Front Back:
DETAILED DESCRIPTION 0'F WORK:
Right Side: Left Side:
FURNISH AND INSTALL A NEW BOAT LIFT
Lot No.
Block No.
-CONSTRUCTION INFORMATION:
Additional work to e e orme under this permit —check
F]HVAC Ei Gas Piping
all'
apply:
Shutters
Q Windows/Doors
Gas Tank
_
11 Electric 0 Plumbing
Sprinklers
Il Generator
Roof Roof pitch
Total Sq. Ft of Construction:
S . Ftofof First Floor:
Cost of Construction: $ 11,000.00
Utilities: —Sewer
Septic
Building. Height:
OWNER/LESSEE:
TOR:
Name GIJANTO, JOSEPH
FName:RT WILLIAMS
ILCO CONSTRUCTION INC
Address:43 SOVEREIGN WAY
City: FORT PIERCE State: FL
Zip Code: 34949 Fax: N/A
Phone No.
Address: 10751 ORANGE AVE
City: FORT PIERCE State: FL
Zip Code: 34945 Fax: 772-460-6929
Phone No. 772460-6928
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
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.
UPPLEMENTALICONSTRUCTION LIEN'LAW INFORMATION:
GINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
Citv:
Zip: Phone: _
x Not Applicable
MORTGAGE COMPANY: x Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name: _
Address:
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 wo*W recording vour Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner I Signature of
Holder
STATE OF FLORIDA -}— j , A STATE OF FLORIDA
COUNTY OF �J l�� C�iJL� COUNTY OF "4- W W -
The f r ing instru nt w s cknowledg efore me
this day of 20 by
'Q(+3rA-
(i mS
( ame of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No. 1il wrL,., CPtlll}'ITZGERALD
MY COMMISSION # GG 162348
A r_voiccc- nn nmhor 17 9091
Bonded Thru ttctary PLUIG Underwriters
Revised 07/15/201
The forgoing inst t was acknowledged before me
KZ
this A day of 20 4�)J_ by
VJ
Name of person acknowledging)
aAVJ�A
(Signature of Notary Public State of Florida )
Personally Known (/ OR Produced Identification
Type of Identification Produced
Commission No.;:PPYe •. DAWN FiTZ(,'Sedl.b
MY COMMSSION # GG 162348
Bonded Thru Notary Public Under.•rriters
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS