HomeMy WebLinkAboutBUILDING PERMIT APPLICATION ,ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
RECEIVED
Building Permit Application AUG 0 4 2021
st.Lucie County
Planning and Development Services Permitting
Building and Code Regulation Division
2300 Virginia Avenue;Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
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;PERMIT APPLICATION FOR: Boat lift DIOC re
P,Rt7PiOSE M M,4'PROVE "I LOCATION
Address: 10701 S OCEAN DRIVE LOT 875,JENSEN BEACH, FL
Legal Description: VENTURE OUT AT INDIAN RIVER INC LOT 875
Property Tax ID#: 4511-510-0076-000-0 Lot No.
Site Plan Name: COSCULLUELA Block No.
Project Name: COSCULLUELA-DOCK&BOAT LIFT
Setbacks Front Back: Right Side: Left Side:
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DETAILED DESCRIPTIOOF WORK
N° t
Furn i s hi a CI OCR (Uf-tv 2-W s6044)
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CO:NSTRUCTlON INFORMATION
itiona work to b
ElGas!Tank
orme un er t is permit—c ec a app❑HVAC ❑Gas Piping Shutters ❑Windows/Doors
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❑Electric OPlu1 bing ❑Sprinklers ❑Generator ❑ Roof Roof pitch
jotal Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 24,00�0.00 Utilities:oSewerE]Septic Building Height:
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OWNER/LESSEE CONTRACTOR: s
Name COSCULLUELA,JUAN&INORMA Name: ROBERT WILLIAMS
'Address:16331 SW 50TH TERR Company: WILCO CONSTRUCTION INC
City: MIAMI State:FL Address: 10751 ORANGE AVE j
Zip Code: 33185 Fax.N/A City: FORT PIERCE State:FL
N/A 34945 772-460-6929
Phone No. Zip Code: Fax:
E-Mail:N/A I 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$2506 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: DANIEL PAUL RETHERFORD Name:
Address:1402 HARTMAN RD Address:
City: FORTPIERCE I State: FL City: State:
Zip: 34947 Phone: 772-224-9626 Zip: Phone:
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FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
;Address: Address:
,City: City:
Zip: Phone: Zip: Phone:
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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.11f you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
,,Signature owf O ner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA r STATE OF FLORIDA '
,COUNTY OF �>a CQ� COUNTY OF ` IC71�d�
The forgoing instru nt was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20 Eby this day of wUJ ,20 by
' ��►� U�it 1.terns _ �IJII�,I�rnS
,(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Knowlb/ ' OR Produced Identification
,Type of Identification Produced I Type of Identification Produced
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Commission No. �Commission No. ��P DAWN(SnatyRALD
MY COMMISSION�#GG 162348 - MY COMMISSION 4 GG 162348
r'� PXPIR S•December 17 2021
lic I 'FpF F;$P' Bonded Thru Notary Public Underv�riters
•,DOFF;, ponied Th,u Notary Pub I erv�riws
Revised 07/15/20 --- i
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
'i COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
'DATE
COMPLETE
'INITIALS
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