HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONJ
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: �1 °t'd55y
•
Building pp Permit Application 3NE7
Planning and Development Services DEC 2 1 2017
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34952 �
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial ReSiderElBl "`"..r.............
PERMIT APPLICATION FOR: Dock/Seawall
PROPOSED IMPROVEMENT LOCATION:
Address: 15 SOVEREIGN WAY, FT PIERCE FL 34949
Legal Description: QUEENS COVE -UNIT 2- BLK 24 LOT A (OR 1420-2105: 2774-1744)
Property Tax ID #: 1414-702-0027-000-4
Site Plan Name: BURD
Project Name: BURD
Setbacks Front Back: _
Right Side: Left Side:
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK:
�arr�ac� "1 Wsg?alaMly
?. l/&fa// " G,, n a inches mletivad Vof 10(0119
CONSTRUCTION INFORMATION:
Additional wor to be nerformed under tis permit—cl
E1HVAC Gas Tank ❑Gas Piping
Electric 0 Plumbing Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ l 5i000. 0
Shutters Q Windows/Doors
Generator Roof Roof pitch
S Ft. of First Floor: _
Utilities:[]Sewer 0Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name WAYNE BURD
Name. ROBERT WILLIAMS
Company: WILCO CONSTRUCTION INC
Address:15 SOVEREIGN WAY
City: FT PIERCE State: FL
Address: 10751 ORANGE AVE
Zip Code: 34949 Fax: N/A
City: FORT PIERCE State: FL
Phone No. 772-460-1085
Zip Code: 34945 Fax: 772-460-6929
E-Mail: N/A
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.52500 or more, a RECOKUED Notice or c:ommencemeni is requires.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applica
Name: DANIEL PAUL RETHERFORD
Address: 1402 HARTMAN RD
CItV: FORT PIERCE
Zip: 34947 Phone: 772-224-9826
State: FL
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone: _
I certify that no work or installation has commenced prior to the issuance of a permit.
x Not Applicable
State:
_Not Applicable
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 vour Notice of Commencement.
Signatu a of Owner/Lessee/Contractor as Agent for Owner
s
Signature 6f Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA c� ! / , , I
COUNTY OF 5f wC�,�COUNTYOF V C--(�rC
The forgoin instr m� ent was acknowledged before me
this dayof �r_ r 20 �2b
pajocb- Wi I 11161Ms
(Name of person acknowledging)
( "�-
re of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced -
Commission No. Are. 1K °`�:
®N#GG162346
•� •
EDecember17,2021
XP:
IRES
.{
r _ � -. \Ie.1oN PIIbOO UIidO
Revised 07/1
The forgoing instrument was acknowledged before me
this i day of (f 20 A2 by
� I u u am�
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known IZ OR Produced Identification
Type of Identification Produced
Commission No.
MY COMMISSION # GG 162M
W
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
7Z �� t
COMPLETE
INITIALS