HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED U c�
Date: �� �1 Permit Number: aid 1Jd� \�O
_a
RECEIVED
Building Permit Application APR 19 2021
Planning and Development Services
Buildingand Code Regulation Division P�rSt. L :g COU'It Department
9 S�. Lucia Coui7ty
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Boat lift I$ LXY_Z_
PROPOSED IMPROVEMENT LOCATION:
Address: 1106 NETTLES BLVD, JENSEN BEACH, FL 34957
Legal Description: NETTLES ISLAND INC, A CONDO -SECTION II PARCEL 1106 AND PRO-RATA SHARE IN COMMON
ELEMENTS
Property Tax ID #: 4502-501-1293-00041
Site Plan Name: WITHERS
Project Name: WITHERS - DOCK & BOAT LIFT
Setbacks Front Back:
Right Side: Left Side:
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK: I
FURNISH & INSTALL A 228 SQ. FT DOCK AND A BOAT LIFT
CONSTRUCTION INFORMATION:
Additional work to a er orme under this permit —check a apply:
�HVAC E] Gas Tank Gas Piping _ Shutters ❑ Windows/Doors
11 Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 30,000.00
S Ft. of First Floor: _
Utilities: Sewer 0 Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name WITHERS, COLLEEN & TODD
Name: ROBERT WILLIAMS
Address: 34 NEW WATER OAK DR
Company: WILCO CONSTRUCTION INC
City: PALM COAST State: FL
Zip Code: 32137 Fax: NIA
Phone No. 904-349-7823
Address: 10751 ORANGE AVE
City: FORT PIERCE State: FL
Zip Code: 34945 Fax: 772-460-6929
Phone No. 772-460-6928
E-Mail: NIA
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: DANIEL PAUL RETHERFORD
MORTGAGE COMPANY: X Not Applicable
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
Name:
BONDING COMPANY: _Not Applicable
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: YouY failure to Record a Notice of Commencement may result in your paying twice for
improvements to your pr erty. A Notice of Commencement must be recorded and posted on the jobsite
before the first'pecti . If you intend to obtain financing, consult with I r or an attorney before
commencing —Work or cording vour Notice of Commencement.
Signature of Owner/Lessee]Contractor as Agent for Owner I Signature
STATE OF FLORIDA �'} / STATE OF COUNTY OF FLORIDA_-
COUNTY OF ��—j— (�lr
The fprgoing instrum nt was acknowledged before me
1 this tP day of 20by
W1 I I I'dM(
(Name of person acknowledging )
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commissio
DAWN FITZGERALD
a ° EXPIRES: December 17, 2021
Revised 07-1 onded Thru Notary Public Underwriters
The forgoing instr ent was acknowledged efore me
this 1_4 day of 20 by
n
(Name of person acknowledging)
.Diu Vii--o
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission N
Lly COMMISSION # GG 162348
Bonded 7hni Notary public Underwriters
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