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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /� �^ Permit Number:
..; SCANNED RECEIVED
Po �'�pg JUN V 52018
Build`1 Noemi Application
Planningand Development Services perSt. Lucing Department
P St. Lucie County
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
PRQPOSEbIMPROVEMENT LOCATIQ°N
Address: 1271 NETTLES BLVD JENSEN BEACH, FL 34957
Legal Description: NETTLES ISLAND INC, A CONDO -SECTION II PARCEL 1271 AND PRO-RATA SHARE IN COMMON ELEMENTS (OR 3140-1051)
Property Tax ID #: 4502-501-1458-000-3 Lot No.
Site Plan Name: RAPER Block No.
Project Name: RAPER - DOCK REPAIR
Setbacks Front Back: Right Side: Left Side:
DOCK REPAIR
FURNISH AND INSTALL NEW STRINGERS & DECKING ONLY (AS NEEDED) ON EXISTING
160 SQ FT DOCK
Additional work to be ertormed under tnls permit — cnecK all apply:
E1HVAC E] Gas Tank Gas Piping _ Shutters [] Windows/Doors
Electric Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S . Ftofof First Floor:
Cost of Construction: $ 3,000.00 Utilities: LJ Sewer Septic Building Height:
Name RAPER, PATRICIA
Address: 1271 NETTLES BLVD
City: JENSEN BEACH State: FL
Zip Code: 34957 Fax: N/A
Phone No. 704-995-3883
E-Mail: N/A
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: ROBERT WILLIAMS
Company: WILCO CONSTRUCTION INC
Address: 10751 ORANGE AVE
City: FORT PIERCE State: FL
Zip Code: 34945 Fax: 772-460-6929
Phone No. 772-460-6928
E-Mail: WILCOINC@BELLSOUTH.NET
State or County License: SCC131151026 29115
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
,e
SUPPLEMENTAL CONSTRUCTI:OWLIEN LAW
INFQRMATION
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: x— Not Applicable
Name: DANIEL PAUL RETHERFORD
Name:
Address: 1402 HARTMAN RD
Address:
City: FORTPIERCE State: FL
City: State:
Zip: 34947 Phone: 772-224-9826
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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, 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 our Notice of Commencement.
i
s
Signaturg of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORID
COUNTY OF COUNTY OF
The for Ing instru as acknowledged efore me The forgoing instrum n was acknowledged before me
thisay of Vb-oy this day of 20 J by
(Name of person acknowledging) (Name of person acknowledging)
(Sill ure of Notary Public- State of Florida) (Signature of Notary Public- State of Florida )
Personally Known �OR Produced Identification Personally KnownLZOR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. _ _ (Sea ft Com I)
DAWN FITMERALD
DAWN FIIZGERALD -'- W COMWSSKNJ # GG 162M
*:
. EXPIRES: December 17, 2021
�i EXPIRES: December 17, 2021 -:FOF �"' pow Th, Notary Public tMdWm*A7 rs
Revised 0 ,offF „ g ThnrNotaryPublicUndedak m
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
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INITIALS