HomeMy WebLinkAboutBuilding Permit Application- .r: T-71-
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: a u
MAI- 15 1011
.... . NMing Permit Application r ment
Planning and Development Services 9"Im T"U" 0 6guntlf
St. �el@
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: goat lift
PROPOSED IMPROVEMENT LOCATION:
Address: 3066 NW RADCLIFFE WAY, PALM CITY, FL 34990
Legal Description: RIVERBEND (PB 67-36) - LOT 18 (OR3938-2590)
Property Tax ID #: 4425-703-0023-000-2
Site Plan Name: ROUNDTREE
Project Name: ROUNDTREE
Setbacks Front Back: _
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
FURNISH AND INSTALL 1 PC NEW BOAT LIFT
Lot No.
Block No.
-CONSTROCTI'0N INFORMATION:
Additional work to je nerformed under tispermit—check all apply:
11HVAC L_J Gas Tank ❑Gas Piping _ Shutters a Windows/Doors
11 Electric 0 Plumbing Sprinklers 1:1 Generator EIRoof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 11,000.00
S Ft. of First Floor: _
Utilities:[]Sewer Septic
Building Height:
" OWNER/LESSEE:
CONTRACTOR:
Name ROUNDTREE, DEBORAH
Name: ROBERT WILLIAMS
Company: WILCO CONSTRUCTION INC
Address:3066 NW RADCLIFFE WAY
City: PALM CITY State: FL
Address: 10751 ORANGE AVE
Zip Code: 34990 Fax: NIA
City: FORT PIERCE State: FL
Phone No. NIA
Zip Code: 34945 Fax: 772-460-6929
E-Mail:
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 requirea.
SUPPLEMENTAL CONSTRUCTION LIEN 'LAW INFORMATION;
DESIGNER/ENGINEER: _ Not Applicable
Name: DANIEL PAUL RETHERFORD
MORTGAGE COMPANY: x Not Applicable
Name:
Address:
City: State:
Zip: Phone:
Address: 1402 HARTMAN RD
City: FORTPIERCE State: FL
Zip: 34947 Phone: 772-224-9826
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.
SignaturlE of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
The for oing instru ent was acknowledged before me
this � day of 20�by
Roy& Wt l
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Co m
k,ly COMMISSION # GG 162348
RevisedRP 1 bonded Thnr Notary Public Undervm�te�rs
c
s
Signature of Contractor/License Holder
STATE OF FLORIDA
� W
COUNTY OF
The forgoing instrument was acknowledged efore me
this _�T_ day of 20 by
Qd06__1_ W,((SANIS
(Name of person acknowledging)
rna 't,",
( ignature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No. 6)1 :. ':'<>6a:.. DAWN
4- MY COMMISSION # GG 162348
Bonded Thru Notary Public Underwriters
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
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REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS