HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ? JOG _
Date: Permit Number:
Building Permit Application R�cENE�
Planning and Development Services JUN. 2 4,10'11
Building and Code Regulation Division artment
2300 Virginia Avenue, Fort Pierce FL 34982 perrn%. 9e County
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential k
PERMIT APPLICATION FOR: Boat lift
I?ROPOSED'IIVIPROVEMENT LOCATION:
[lririracc 126 QUEEN BESS CT, FORT PIERCE, FL 34949
Legal Description: QUEENS COVE - UNIT 1 - BILK 16 LOT E
Property Tax ID #: 1414-701-0151-000-9
Site Plan Name: WHITEHEAD
Prniart Name: WHITEHEAD - DOCK & BOAT LIFT
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK;,
/nJfa 491mfio l 1910a4 /lam r l& e
Lot No._
Block No.
li'CONSTRUCTIOWINFORMATION:
Additional work to be nerformed under tispermit-check
11HVAC ❑Gas Piping
all
apply:
Shutters
a Windows/Doors
Gas Tank
_
Electric 0 Plumbing
Sprinklers
Generator
Roof Roof pitch
Total Sq. Ft of Construction:
23,000.00
S�Ftj of First Floor:
O
Cost of Construction: $
Utilities:
LJ
Sewer
Septic
Building Height:
,',OWNER/LESS'EE:
CONTRACTOR:
Name WHITEHEAD, HARDOLD & ELIZABETH
Name: ROBERT WILLIAMS
Address: 6292 HOLLY CT
Company: WILCO CONSTRUCTION INC
City: BUFORD State: GA
Address: 10751 ORANGE AVE
Zip Code: 30518 Fax. N/A
City: FORT PIERCE State: FL
Phone No. 770-365-1390
Zip Code: 34945 Fax: 772-460-6929
E-Mail: N/A
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 52500 or more, a RECORDED Notice of Commencement is requirea.
S'UPPLEMENTAL'CONSTRUCTION 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
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 woA-or-recording your Notice of Commencement.
Signature of Own a Contractor as Agent for Owner I Signature of
STATE OF FLORIDA I , . STATE OF FLORIDA r
COUNTY OF COUNTY OF W
The f r oing instrument was acknowledged before me
this Un day o<7Ur'R_ , 20C-2341—by
(Name of person acknowledging)
4t)�_ -
Signature of NotaryyPPublic- State of Florida )
Personally Known"1OR Produced Identification
Type of Identification Produced
Commission No.
Revised 07/15/20
The forgoing instrument was acknowledged before me
this j day of �( Ii'l-�. , 20 � by
c�eA- WdttCaU
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known V OR Produced Identification
Type of Identification Produced
D "�'�!�jj�ZGE ALD I I Commission Q,t Ye�� •. DAWN FI7ZGER4@�al)
MY CO i�1il ## GG 162348 _ ?' ;¢. MY COMMISSION #i` GG 162348
EXPIRES, C ecemfaer 17, 2021 111.r-� f_;YPIRES: December V. 2021
Bonded Toni Notary Public Underwriters
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