HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COR,J.',_�TED, FOR APPLICATION TO BE ACCEPTED
Date: 3�Z2��� SGAWt4ED Permit Number: lips -
N_. t. �v'i
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Dock/Seawall
I
.PRO,POSED IMPROVEMEN T'-,Lb ' iON
Address: 3100 NW RADCLIFFE WAY
Legal Description: RIVERBEND (PB 67-36)- LOT 19
Property Tax ID #: 4425-703-0024-000-9 Lot No.19
Site Plan Name: RIVERBEND Block No.
Project Name: JAMES DOCK & LIFT
Setbacks Front Back: Right Side: Left Side:
DETAILED. DESCRIPTION :OF WORK
CONSTRUCT A DOCK & (1) BOAT LIFT, P.l�,Zk(z-P.e_� UtJoefL--
CONSTRUCTION �IN'FORMATIO'N
itiona wor to e e orme un er t is permit — Check all I= apply:
[_1HVAC Gas Tank ❑Gas Piping _ Shutters ❑ Windows/Doors
Electric Q Plumbing Sprinklers E] Generator F]Roof Roof pitch
Total Sq. Ft of Construction: S. FFttj. of First Floor:
Cost of Construction: $ �,�0 Utilities: !Sewer Septic Building Height:
OWN ER/LESSEE
CONTRACTOR:
NameCAROL & JOHN JAMES
Name: �►L
Address:3100 NW RADCLIFFE WAY
Company: TREASURE COAST BARGE, INC
City: PALM CITY State:FL
Address: 1200 SE CUTOFF ROAD
Zip Code: 34990 Fax:
City: PALM CITY State: fI
Phone No.561-214-0309
Zip Code: 34994 Fax: 221-1611
E-Mail:Cwatsonjames@aol.com
Phone No. 201-9777
Fill in fee simple Title Holder on next page ( if different
E-Mail: JERNER@BELLSOUTH.NET
from the Owner listed above)
State or County License: 20077
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
I/
SURPLEIVIENTALCONSTRU N ���:CE°N°LQUII INFOR�MATIQN4
SIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: CAROL & JOHN JAMES
Name: LISA JULIANO
Address: I
Address: 3100 NW RADCLIFFE WAY
City: PALM CITY State:
City: PALM CITY State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:1200 SE CUTOFF ROAD I
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 hermit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the FloridaBuilding 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 attnpy before
commencing work or recording our Notice of Commencement.
l
Signatur6 of Owner/ Lessee/Contractor as Agent for Owner
SigkAure of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORI�-
COUNTY OF M Q fki 1--,
COUNTY OF
The forgoing instrument was acknowledged before me
"1�
The f rgonstru �yg�t was cknowledged efore me
this oQ3 day of 1�'U a� r-vL 20) � by
this Q day of �S%t- 20_U by
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II �l \C �0��� I .,6l ` J—
Name of person making statement
Name of per�gp making statement
'x
Personally Known OR Produced Identification V/
Personally Known OR Produced Identification
Type of Identification %Type
Produced I'L, IDY1 VV1 LA
of Identification
Produc ,
Y
(Signature of Notary Public- State of Florida)
(Signature of Notary Pu lic- State of Florida )
Edith 71
Commission No. Q7 (OZ 35 State ofFl(rlffPmmission
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No. (Seal)
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es 03/28/2020
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