HomeMy WebLinkAboutBUILDING PERMIT APPLICATION,
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q
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Date: % rJ_ k $ )y Permit Number:
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Building Permit Application `E
Planning and Development Services nrr 18
Building and Code Regulation Division Pertnitt/ 2�%B
2300 Virginia Avenue, Fort Pierce FL 34982 fit, LwcQepartme
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residentiaigun4, %
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PERMIT APPLICATION FOR: Dock/Seawall
Address: 10701 S OCEAN DR LOT 669 �7�1r ,tAnj4F_tj
Legal iDescription: VENTURE OUT -SECTION C- LOT 70 (OR 3352-752)xI= L1,,18 r.G;,,#v
Property Tax ID #: 4511-805-0070-000-3 Lot No.
Site Plan Name: CICCONE Block No.
Project Name: CICCONE
Setbacks Front ilk Back: Right Side: Left Side:
Total Sq. Ft of Construction:
Cost,of Construction: $ J. 00c) • ��
S�Ftj of First Floor: _
Utilities: LJ Sewer 0Septic
NarrIeROCCO CICCONE
Address: 10701 S OCEAN DR LOT 669
City JENSEN BEACH State:FL
Zip ;Code: 34957 Fax: N/A
Phone No. N/A
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E-M a i I : N/A
Fill in fee simple Title Holder on next page ( if different
from the owner listed above)
Name: ROBERT WILLIAMS
Building Height:
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
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
29115
NGINEER: _ Not Applicable
Name: DANIEL PAUL RETHERFORD
Address: 1402 HARTMAN RD
City: FORT PIERCE State:
Zip; 34947 Phone: 772-224-98e6
FL
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
Address:
City:
Zip: I Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone: _
I certify that no work or installation has commenced prior to the issuance of a permit.
x Not Applicable
State:
Not Applicable
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which lis 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,
access) ry 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 your Notice of Commencement.
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Signature of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA �Lu�- COUNTY OF
The fo going instrument was acknowledge efore me .
this day of 20 Mby
(Name of person acknowledging )
au &
(Signature of Notary Public- State of Florida )
Personally Known " OR Produced Identification
Type of Identification Produced
J
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Signature of Contractor/License Holder
STATE OF FLORIDA / r i ��
CO U NTY OF ��lil.
The forgoing instrum nt was acknowledgeq before me
this _L day of �� 20 by
(Name of person acknowledging)
IALOJ
(Signature of Notary Public- State of Florida )
Personally Known V OR Produced Identification
Type of Identification Produced
Commission No. Commission No.
,; DAWN FITZGERAID
• : MY COMMISSION # GG 162348
;r dos EXPIRES: December 17, 2021
Revised07/15/ Y�4FF`°'• wow-ffiru tarYPu6IicU rv,�ters
pqgWZGERAW
MY COMMISS ON # GG 162348
EXPIRES: December 17, 2021
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