HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1�S -a Permit Number:
' RECEIVED
����'� � �`�' Building Permit Application OCT 12 2020
St.Lucie County
Planning and Development Services Permitting
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
Address: 12416 S Indian River Dr
Property Tax ID#:4504-603-0016-001-2 Lot No.
Site Plan Name: 12416 S Indian River Dr Block No.
Project Name: Casey Dock
DITAII FD DECRI.PTION OF
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Remove existing 366 SF dock and replace with new 1020 SF dock
Install two (2) 16K 4-post lifts
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORII/IATIC)N
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Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank —Gas Piping _Shutters _Windows/Doors _Pond
_X_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: 011�:N Sq. Ft. of First Floor: na
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Cost of Construction: $ � � , ®z) Utilities: _Sewer _Septic Building Height:
C}WNER/LESSEE CONTRACTOR
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NameDaniel A Casey Name:Donald Duncan
Address: 12416 S Indian River Dr Company:Palmera Construction Group Inc
city:Jensen Beach FL State:_ Address:3094 SW Seaboard Ave
Zip Code:34957 Fax: City: Palm City State:FL
Phone No. Zip Code:34990 Fax:
E-Mail:dancaseybroward@gmail.com Phone N0772-634-6961
Fill in fee simple Title Holder on next page(if different E-Mailjoy@palmeraconstruction.com
from the Owner listed above) State or County LicenseCGC1530542
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
If value of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INI=ORMATION';
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DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: X Not Applicable
Name:Loudon & Assoc Name:
Address:PO BOX 1138 Address:
City: Port Salerno State: FL City: State:
Zip: 34992 Phone772-223-0105 Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: X Not Applicable
Name: Name:
'I Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender qr an attorney before commencing work or rgcQrding your Notice of Commencement.
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Signature o wner/L ssee/ o actor as ent for Owner Signature of Contractor License Holder
STATE OF FLOPJDA �t STATE OF FLORIDA
COUNTY OF COUNTY OF MARTIN
Swoph to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Pp wysical Pre - ce r Online Nq arization Physical Presence or Online Notarization
this—4L day of 2024 by this day of 2020 by
Daniel Casey _- Donald Duncan
Name of person making statement. Name of person making statement.
P sonally K own OR Produced Identification ✓ Personally Known OR Produced Identification
T of Ide t icatio Type of Identification
Pr uced Pro
(Sig ature of Not blic-Stat4 of Flori g` ,r Ma I
� Cam H r u IIo � W � rid �0
Commission No. 5 4� ! , My com li rhWE'Pn z PUe�oO aull$!�UO Hof o=
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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