HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION'TO BE ACCEPTED
Date: Permit Number:a 02 O ��
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 Residential X
PERMIT APPLICATION FOR: Boat lift
PROPOSED'IMfPROVEMI'ENT LOCATION:
Address: 133 PARLIAMENT CT, FT PIERCE, FL 34949
Legal Description: QUEENS COVE - UNIT 1 - BK 17 LOT E
Property Tax ID #: 1414-701-0162-000-9 Lot No.
Site Plan Name: HENRY Block No.
Project Name: HENRY - BOAT LIFT
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: '
I l� /0Cl�%itsfil? /
CONSTRUCTION INFORMATION:
Additional work to pe nej orme un er t 1s permit — check a apply:
11HVAC LJ Gas Tank []Gas Piping Shutters a Windows/Doors
1-1 Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 3,500.00
S Ft. of First Floor: _
Utilities: 0 Sewer 0 Septic
Building Height:
:.OWNER/LESSEE: -
„ ,.
CONTRACTOR:
Name RALPH W HENRY SR (LF EST)
Name: ROBERT WILLIAMS
Address:133 PARLIAMENT 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. 609-226-6180
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 requires.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: x Not Applicable
Name:
_
Address: _
City: State:
Zip: Phone:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x— Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
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.
1
Signature of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA � U
�/COUNTY OF
The forgoing instru ent was acknowledgeq before me
this day of d 20by
Rib44- an
(Name of person acknowledging)
(Siiggnature of Notary Public- State of Florida )
Personally Known _� OR Produced Identification
Type of Identification Produced
�y
S
Sigma of Contractor/License Holder
STATE OF FLORIDAJ
COUNTY OF w
The f r oing instrumerlh.w1as acknowledged before me
this day of ' , v q 20 _Q1 by
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known V OR Produced Identification
Type of Identification Produced
Commission No. _o"`" gel;. DAWNS•Liai�ERALD ! I Commission No.
MY COMMISSION # GG 162348
Bonded Thru Notary Public Underwriters
Revised 07/
DAWN Fk�(Tg'� r LD
COMMISSION # G 162348
o EXPIRES: December 17, 2021
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