HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �T� Permit Number: C I
b
z RECEIVED
Building Permit Application NOV 0 9 2018
Planni I g and Development Services ST. Lucie County,
ounty Per '
Building and Code Regulation Division mitting
2300 Virginia Avenue, Fort Pierce FL 34982
PhoneI: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIIT APPLICATION FOR: Dock t_b0Ct+a+
SCANNED
PROPOSED IMPROVEMENT LOCATION: BY
Arlrlrpss'. 10701 S OCEAN DR LOT 646 JENSEN BEACH, FL 34957 St Lucie County
Legal Description: VENTURE OUT -SECTION C- LOT 47 (OR 1016-1084)
Property Tax ID #: 4511-805-0047-000-3
Site Plan Name: STEVENS
Prniprt Namp- STEVENS - DOCK & BL
i
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
1. FURNISH AND INSTALL A 88 SQ FT +/- DOCK
2. FURNISH AND INSTALL 1 PC HI TIDE BOAT LIFT
Lot No._
Block No.
CONSTRUCTION INFORMATION:
Additional work to e e orme under this permit —check a apply:
E'HUAC E] Gas Tank []Gas Piping _ Shutters a Windows/Doors
LJ Electric 0 Plumbing Sprinklers El Generator Roof Roof pitch
Total Sql Ft of Construction: S . Ft. of First Floor:
11,000.00
Cost of Construction: $ Utilities: Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name TIED & SUSAN STEVENS
Name: ROBERT WILLIAMS
Addressli: 10701 S OCEAN DR LOT 646
City: JENSEN BEACH State: FL
Zip Codle: 34957 Fax. N/A
Phone No. 772-260-1943
E-Mail: N/A
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
Fill in feie simple Title Holder on next page (if different
from the Owner listed above)
E-Mail. WILCOINC@BEL'LSOUTH.NET
State or County License: SCC131151026 29115
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN'LAW INFORMATION: J
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: x Not Applicable
N am e: l DANIEL PAUL RETHERFORD Name:
Ad d ress: 1402 HARTMAN RD Address:
City: FORT PIERCE State: FL City: State:
Zip: 34947 Phone: 772-2249626 Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: _Not Applicable
Name:; Name:
Address: Address:
City: I City:
Zip: Phone: Zip: Phone:
I certify ithat 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,
accesso i 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.
—_ s
essee/Contractor as Agent for Owner Signature of C ntractor/License Holder
STATE OF FLORIDA � Luo-,
COUNTY OF
The forgoing instr m nt was cknowledged Pefore me
-,
this -- day of (� 20 by
t,
(Name of person ackpowledging )
(Signature of Notary Public- State of Florida )
Personally Known V/OR Produced Identification
Type of Identification Produced
Commission N
0 MY COMMISSION # GG 162348
vnnee. neromYwr 17 90?i
STATE OF FLORIDA (a— (, �
COUNTY OF 1/�
The forgoing instrurnent was ac nowledgebefore me
this __X day of k W 0 Q by
kpb,gA—
X4 va�lwa
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No.
MY COMMISSION # GG 162348
,�'TFOF F`�N. Bonded ThN Notary Public Undemiters • `rf d,F;;°"' Bonded Thtu Notary Public Underwittels
Revised 07/ 1,
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