HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED • 7i2�
Date: 5 8CANNO Permit Number: I P15
BY
St Lucie Couhty
AY 08.2018
Building Permit Application "armittin
Planning and Development Services �' �21tou��!nenr
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Dock/Seawall
I
PROPOSED IMPROVEMENT LOCATION: {
Address: 3264 LAKESHORE DR MARINA SLIP # 64
11
Legal Description: LAKESHORE AT SANDS (OR 1640-1I177) UNIT 11
Property Tax ID #: 1425-676-0011-000-5
Site Plan Name:
Project Name: MAZZELLA DOCK ADDITIONS
Setbacks Front Back: Right
DETAILED DESCRIPTION OF WORK':
INSTALL A BOAT LIFT AND CONSTRUCT A FINGER PIER EXTENSION
i
Left Side:
Lot No. SLIP 64
Block No.
CONSTRUCTION INFORMATION:
Additional work to be nerformed under this permit— check all apply:
[1HVAC Gas Tank ❑Gas Piping _ Shutters Q Windows/Doors
R1Electric Plumbing Sprinklers El Generator F1 Roof Roof pitch
Total Sq. Ft of Construction: . ��„, S Ft. of First Floor:
Cost of Construction: $ v O Utilitie"c _ Sewer E]Septic Building Height:.
OWNER/LESSEE:
CONTRACTOR:
Name FRANK MAZZELLA
Name: CEBRONE ATKINS
Address:3264 LAKESHORE DR
Company: SAMSON MARINE CONSTRUCTION, LLC
City: FORT PIERCE . State:FL
Zip Code: 34949 Fax:
Phone No.407-399-7502
Address: 516 BAY ROAD
City: NORTH PALM BEACH, State: FL
Zip Code: 33408 Fax:
Phone No. 772-713-7803
E-Mail:frankmazzella@me.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: SAM.DURHAM85@YAHOO.COM
State or County License: CGC1517960M
IIIf value of construction is.$2500 or more, a RECORDED Notice of'Commencement is required. I
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: PAUL WELCH ING
Address:1984 SE BILTMORE 4114
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
City: PORT ST LUCIE State: FL
Zip: 34982 Phone 785-9888
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
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 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, signsi 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.// !J
�Q 91
Signature of Owner/ Lessee/Contractor as Agent for Owner I Signature of Contractor/License Holder
STATE OF FLORID // STATE OF FLORIDA
COUNTY OF COUNTY OF .17�t1%f�i%Z
The forg ing instrume t was acknowledged before me
this Iq day of 20
�RAVI �� z �� 4.
Name of person making statement
Personally Known �/ OR Produced Identification
Type of Identification
Produced
The for ling instrument was acknowledgedbefore me
this ir day of HALA 20_1& by
C
Name of person m g statement
Personally Known lollll OR Produced Identification
Type of Identification
gnature of Notary PVVs§_ to I� N g:4
G ION'#
(Signat re of Notary Public-
ate of Florida )tMY
F 17
FF177951EXPIRES:i@�gmber 10, 2018
Commission No. �
Notary
Commission No. pgY Kathleen �al Ruesga
A i55 1
P � IC
oo Banded fire Budget Services
�d
oe,�IOTARY
-STATE OF FLORIDA
C-omm#-GG-1 69
REVIEWS FRONT ZONING SUPERVISOR
PLANS VEGETATI E1
SE/ Wi gl4t 93ANGROVE
COUNTER REVIEW REVIEW
REVIEW REVIEW
REVIEW REVIEW
DATE
ai
RECEIVED�5u
iI
4
DATE
COMPLETED
Rev. 8/2/17