HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: `�'• �d ' bG SCANI�2131nit Number: n 21
BY
Sti Janie County RECEIVED
Building Permit Application APR 3 0
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Comm rcial
Lu10
�T. Lucie County, Permitting
Residential X
PERMIT APPLICATION FOR: Boat lift I 0
PROPOSED -IMPROVEMENT LOCATION: t'
Address: 3042 NW Radcliffe Way, Palm City, FL 34990
Legal Description: Riverbend (PB 67-36)-Lot 12 I
Property Tax ID #: 442570300170007
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side
DETAILED DESCRIPTION -OF WORK:
Install 2 ea. 4 piling HiTide Boat Lifts (NOTE: Elect
Lot No.12
Block No.
Left Side:
I to be pulled on a separate permit)
CONSTRUCTION INFORMATION:
Additional work to be nertormed under tis permit --check
EIHVAC L_J Gas Tank ❑Gas Piping
all
app y:
_ Shutters
a Windows/Doors
Electric ❑ Plumbing
[]Sprinklers
F]Generator
Roof Roof pitch
Total Sq. Ft of Construction:
Sq.of First Floor:
Cost of Construction: $ 28025.00
Uti ities: LJSewer Septic
1
Building Height:
OWNER/LESSEE: ;
CONTRACTOR:
Name Jim Covey
Name: Maurice Petz
Company: Linden Marine Construction, Inc.
Address:3042 NW Radcliffe Way I
City: Palm City State: FL I
Address: 2469 SE Dixie Highway
City: Stuart State: FL
Zip Code: 34990 Fax: I
Phone No.772.770.6160 I
Zip Code: 34996 Fax:
E-Mail:jim@jcoveylaw.com I
Fill in fee simple Title Holder on next page (if different
Phone No. 7723490727
E-Mail: lindenmarine@yahoo.com
from the Owner listed above) I
State or County License: SLC18466
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
N a m e : Roger Baber
Address: 4050 Seivitr Road
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Clty: State:
Zip: Phone:
City: Ft Pierce State: Ft
Zip: 34981 Phone6aa544-0735
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING
Dame:
�ddress:
COMPANY: Not Applicable
tty:
ip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby mad6 to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the iss ance of a permit.
St. Lucie County makes no representation that is granting a permit ill authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association ru es, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and r view your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereb 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 r oms 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/) /1
for Owner
Signature Contractor/License Holder
Signature of Owner/ Lessee Contractor as Agent
of
STATE OF FL RIDA
STATE OF FLORIDA
COUNTY OF N
COUNTY OF
The for oing instrument was acknowledged before me
The forgoing ins umep was acknowledged before me
this day of 20M by
this _LO day of h
20JS by
r
l�lll au� `� cam• fie-%
i r e
Wau v-
e-F�
—. Name of person making statement
Name of person making statement
Personally Known O. OR Produced Identification
Personally Known J�--
OR Produced Identification
Type of Identification
Type of Identification
Produced JAMIE PUGH
Produced
:O.M'"""L°O� My COMMISSION #GG047204
y EXPIRES- NOV 14, 2020
a Bonded thruuO Isi State Insurance)
5471 • J
(Signaturi LAWPublic-State of Florida)
(Sig u e &ota77r&r11
SION#GG047204
EXPIRES: NOV 14, 2020
Commission No. (Seal)
I
I
Commission No.
*h .
Bonded tState insurance
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tev. 8/2/17