HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONr .-
1
ALL APPLICABLE INFO MUST BE
Date: • U . � 0
A
FOR APPLICATION TO BE ACCEPTED
1%^ifi kILMM . Permit Number: I
SJBY
Niecourdy RECEIVED
Building Permit Application MFqR o s
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462 553 Fax: (772) 462-1578 Commercial
PERMIT APPLICATION FOR: Docki
PROPOSED IMPROVEMENT LOCATION:
Address: 3066 NW Radcliffe Way, Palm
, FL 34990
Legal Description: RIVERBEND (PB 67-36) - LOT 18
Property Tax ID #: 4425-703-0023000-2
Site Plan Name: ROUNDTREE
Project Name: ROUNDTREE
Setbacks Front Back: _
3938-2590 )
Right Side:
DETAILED DESCRIPTION OF WORK: ",,
FURNISH AND INSTALL 1 PC. UP TO 192 SQ. FT.
2010
ST. Lucie County, Permitting
Residential X
Left Side:
TING KAYAK DOCK
Lot No.
Block No.
CONSTRUCTION INFORMATION:
Additional work to be nerformed under tispermit—check all apply:
1
❑HVAC _ Gas Tank []Gas Piping M Shutters ❑ Windows/Doors
❑Electric ❑ Plumbing []Sprinklers ❑'Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 15,000.00
1
Sq. Ft. of first Floor: _
Utilities: _ Se ; er ❑Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name DEBORAH ROUNDTREE
Name: ROBERT WILLIAMS
Address: 3066 NW RADCLIFFE WAY
Company: WILCO CONSTRUCTION INC
City: PALM CITY State: FL
Address: 10751 ORANGE AVE
Zip Code: 34990 Fax: N/A
City: FORT PIERCE State: FL
Phone No. 858-877-0081
Zip Code: 349,45 Fax: 772-460-6929
Phone No. 7727460-6928
E-Mail: DEBORAHROUNDTREE@YAHOO.COM
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
i
If value of construction is $2500 or more, a RECORDED Notice of Commencement is
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: DANIEL PAUL RETHERFORD I
Address: 1402 HARTMAN RD
City: FORT PIERCE State: FL
Zip: 34947 Phone: 772-224-9826
1
MORTGAGE COMPANY: X Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
Address: 1
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
City:.. 1
Zip: Phone: 1
1
Zip: Phone:
I certify that no work or installation has commenced prio
St. Lucie County makes no representation that is granting
which is in conflict with any applicable Home Owners Assi
structure. Please consult with your Home Owners Associa
the issuance of a permit.
rmit will authorize the permit holder to build the subject structure
ion rules, bylaws or and covenants that may restrict or prohibit such
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
improvements to your property. A Notice of Comme
before the first inspection. If you intend to obtain fin
commencine work or recording vour Notice of Comrr
Signature of O�/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA S-f W(b
COUNTY OF
The forgoing instru acknowledged before me
as
this aday of M20 by
Qom-
(Name of person acknowledging)
(Signature of Notary Public- State of Florida ) ub
Personally Known ✓ OR Produced Identification
Type of Identification Produced
of Commencement may result in your paying twice for
icement must be recorded and posted on the jobsite
incing, consult with lender or an attorney before
encement.
J
S
Signature of Contractor/License Holder
ATE OF FLORIDA
)UNTY OF
e for oing instru t was acknowledg- before me
s day of 20 by
of person acknowledging )
(Signature of Notary Public- State of Florida )
Perso ally Known OR Produced Identification
Type of Identification Produced
Commission No. FIIZGERALD Commission No.
1
My COMMISSION # GG 162346 1
I �,EoQ � Bonded Th� Netary PUbiIC Undenrrtiteis
Revised 07/ 15/2014
DAWN F(SWM1RALD
MY COMMISSION # GG 16M
EXPIRES: December 17, 2021
Bonded Thru Notary Public UrKler #ft
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS