HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: I (I-c ' 1 g
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Building Permit Application DEC 0 7 2017
Planning and Development Services PERFpITTING
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Dock
PROPOSED IIUIPROVEMENT LOCATION :
Address: 3913 SHORESIDE DR, FT PIERCE, FL 34949
Legal Description: TARPON FLATS SUBDIVISION (PB 69-27) LOT 7 (OR 3905-2857)
Property Tax ID #: 1423-566-0010-000-4
Site Plan Name: BAKER
Project Name: BAKER
Lot No. 7
Block No.
Setbacks Front Back: Right Side: Left Side:
DETAILED�DESCRIPTION OF WORK r
u" 7 idh%fill /pn * 3so� �o
Up 7b -F� 0/ i
CONSTRUCTION 1XFORMATION ,... -h.
y
Additional work to e e orme under er this permit - check a apply:
0HVAC Ei ❑ Gas Piping Shutters Gas Tank _❑Windows/Doors
Electric 0 Plumbing Sprinklers E Generator 1:1
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction: $ 23,000.00 Utilities:Sewer 0Septic
Roof Roof pitch
Building Height:
O:UVlNER%LESSEE ., �
_CONTRACTOR _
Name SETH AND MARY BAKER
Address: PO BOX 643700
City: VERO BEACH State: FL
Zip Code: 32964 Fax: NIA
Phone No. - 13 -Q 9d
Name: ROBERT WILLIAMS
Company: WILCO CONSTRUCTION
p Y=
INC
Address: 10751 ORANGE
AVE
City: FORT PIERCE
Zip Code: 34945
Phone No. 772-460-6928
state: FL
Fax: 772-460-6929
E-Mail: y` M 0 \0_ S
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
If vnlnn of
E-Mail: WILCOI NC@BELLSOUTH.
NET
State or County License: SCC131151026
29115
SUPPLEMENTAL CONSTRUCTION LIEN LAIN fNFORMATION
NER/ENGINEER: _ Not App
Name: DANIEL PAUL RETHERFORD
Address: 1402 HARTMAN RD
City: FORT PIERCE
Zip: 34947 Phone: 772-224-9826
State: FL
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: AillA
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name: kJ
Address:
City: State: _
Zip: Phone:
BONDING COMPANY: Not Applicable
Name: AJ-1/1
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 prope y. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspe ' n. If ou intend to obtain financing, consult with lender or an attorney before
comAerlcing work r rec r g your Notice of Commencement.
as Ageriftor Owner
STATE OF FLORIDA/4 %CPQ
COUNTY OF
The f oing instr t was ack dged efore me
thisday of wle20 fby
(Nanfe ol person ackn w edging )
(Signature of Notary
yPPublic- State of FI ida )
Personally Known O P o
Type of Identification Pro c fy Rublia State nf Florida
Frances Donza
Commission No. Boa My(Segbission GG 092440
o, ridgy Expires 67/27/2021
Revised 07/ 15/2014
s
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
The forgoing instrument w s� acknowledged before me
this I day of r 20 R by
wll 1�rC@ n(
(Name of person acknowledging)
aw I-VuL
(Signature of Notary Public- State of Florida )
Personally Known tll.�OR Produced Identification
Type of Identification Produced
mission
MY COMMISSION N FF o77529
EXPIRES: December 17. 201
lonae iN otary public Undeiwrilem
REVIEWS
FRONT
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SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
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DATE
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COMPLETE
INITIALS