HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: 0— l k— W Permit Number: 4 I b —o3921
RECEIVED
- 04
Building Permit Application OCT 18, 2010 S`
Manningand Develo ment Services t Lucie
P Permitting Department
Building and Code Regulation Division St, Lucie County
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Dock 0
Address: 10701 S OCEAN DRIVE LOT 811 JENSEN BEACH FL FL
Legal Description: VENTURE OUT AT INDIAN RIVER INC LOT 811 (OR 4033-616)
Property Tax ID H: 4511-510-0012-000-4 Lot No. 811
Sitel Plan Name: ORR Block No.
Project Name: ORR
I
Setbacks Front '; Back: fight Side: OLA Left Side:
1.II, INSTALL 1 PC. 0 SQ. FT DOCK (D Sl kk
2J REMOVE AND REINSTALL EXISITNG BOAT LIFT
I �
"Shutters
FIGenerator
Windows/Doors
Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 5,000.00 Utilities:0Sewer OSeptic Building Height:
Name MATT ORR
Add ress:6534 SW 9TH ST
Cit�: OKEECHOBEE State:FL
Zip Code: 34974 Fax: N/A
Phone No.863-623-7829
E- ail: N/A
Fill n 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 LicenseW I &ISIn i I) Q9'l(
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SIJPPLEMENTAL;CONSGTRUCTION LIEN�L`�RW�iNFORMAT(ON ���r�� '�� � � � � ��� s� F;
_
DESIGNER/ENGINEER: _
Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City. State:
Zip:l Phone
Zip: Phone:
FE(SIMPLE TITLE HOLDER: _
Not Applicable
BONDING COMPANY:
Not Applicable
Name:
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, 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 rQording your Notice of Commencement. _
ture of
as Agent for Owner I Signature of
r
STATE OF FLORIDA STATE OF FLORIDA 5��
COUNTY OF COUNTY OF J
The Forgoing ins tr n w s acAnPwledge �iefore me
this day of (%f' 20 4by
►anus
Name of person r�2king statement
Personally Known V OR Produced Identification
Type of Identification
Produced
I "Al
The forgoing instrur nt s n Wedged before me
this I day of V 20A by
- Name of pers- oryrfiaking statement
Personally Known V OR Produced Identification
Type of Identification
Produced
iature of Notar Pa0.." "ate of CAY 11TZGERALD
(Signature of Nota
:�;
MYCOMMISSION # GG 162348
�iAVP
DAWN FITZGERAI D
mission No. m. :�=
EXPIRES( )nber17,2021
Commission No. =g =
?,Ay COMMI$SKM f GG162348
rFOF Fy°p'
ponded Thm Notary Public Underwriters
=� : .ems;
EXPIF:ES. December 17, 2021
'y Foy d�°e°
L�onded Thru Notary Pubric Ureletwrne►s
/IEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.9/2/17
PERMIT # I ISSUE DATE
PLANNING & DEVELOPMENT SERVICES SCANNED
Building & Code Compliance Division RECEIVED St'Lue By
a Count
y
BUILDING PERMIT OCT 18 2018
SUB -CONTRACTOR AGREEMENT
Permitti�
St. Lu iC Q cQu� y ent
pany Name/Individual Name)
the C 1-,
(Type of Trade)
For
It is
prof
project located at
✓t c n I e o,- tvt L e -1-t4c have agreed to be
Sub -contractor for &01 1 L 0 C04,1 S f" C,C_ It �"L"
(Primary Contractor)
0 70 L S CC 1-4 "
(Project Street Address or Property Tax ID #)
d //
that, if there is any change of status regarding our participation with the above mentioned
the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
of a Change of Sub -contractor notice.
C
CONY I_CCTOR SIGNATURE (Qualifier)
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of
The foregoing Instrument was signed before me this l day of
20 L8 by _�< e1� VJI[l I (�YaJ
who Is personally imown _(6r bas produced a
as
Of
SUB -CO ACTOR SIGNATURE (Qualifier)
PRINT NAME
A C7 9 39-
COUNTY CERTIFICATION NUMBER j
State of Florida, County.,
The foregoing instrument was signed before me this I day of
e< 2o-L6by
who is personally Imown _or has produced a
as Identification STAMP
,ublic Signature of Notary Public
t4L
Public Print Name of Notary Public
PL DAWN FITZGERALD
' MY COMMISSION # GG 16298
EXPIRE : Dece 2021 ;r P' GERALD
DAWN FITZ
< ;oa? g tuber 17, : MY COMMISSION # GG 162348
;RUFe�?�` B011d�1111UNo12lYpuhlicUl►delvaiters EXPIRES:Decembet1T,2021
°?r' ot UncEe<vrr7tets
,00ri� +' 'sir F�� 8011dedT11N:�Y �
STAMP