HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �� Permit Number.
RFC
On, L90
Building Permit Application
Planning and Development Services
Building and Code Regulation Division C%
2300 Virginia Avenue, Fort Pierce. FL 34982 sy��.hv'r X OG/&
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Dock/ (30aif lJr-
PROPOSED IMPROVEMENT LOCATIONS
Address: 10701 S OCEAN DR LOT 881 JENSEN BEACH, FL 34957
Legal Description: VENTURE OUT AT INDIAN RIVER INC LOT 881 (OR 3795-745)
Property Tax ID it: 4511-510-0082-000-5
Site Plan Name: SEPE '
Project Name: SEPE - DOCK 8, BOAT LIFTS
Setbacks Front Back:
,,DETAILED, DESCRIIPTION'OrWORK:
Right Side:
Left Side:
1. FURNISH AND INSTALL A 220 SQ FT +/- DOCK
2. FURNISH AND INSTALL 1 PC. 4,500 LB CAPACITY BOAT LIFT
3. FURNISH AND INSTALL 1 PC. 12,000 LB CAPACITY BOAT LIFT
CONSTRUCTION ,'IN FORMATION:
L.JHVAC LJGas Tank UGas
Electric 0 Plumbing DSpr
Total Sq. Ft of Construction:
Cost of Construction: $ 30,000.00
11.
Piping
ars I J Generator
S Ft. of First Floor: T
Utilities:-MSewer 0Septic
Lot No.
Block No.
❑Windows/Doors
DRoof = Roof pitch
Building Height:
OWNERAESSEE:
CONTRACTOR:,
Name ADRIANA 8 DANIEL SEPE
Name: ROBERT WILLIAMS
Address:7961 SW 148TH STREET
Company: WILCO CONSTRUCTION INC
City: PALMETTO BAY State: FL
Zip Code: 33158 Fax: NIA
Phone No.786-247-4485
Address: 10751 ORANGE AVE
City: FORT PIERCE State: FL
Zip Code: 34945 Fax: 772-460-6929
Phone No. 772460-6928
E-Mail: NIA
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: WILCOINC@BELLSOUTH.NET
State or County License: SCC131151026 29115
If value of construction Is 52500 or more, a RECORDED Notice of
required.
A
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: III
Name: DANIEL PAUL RETHERFORD
Address: 1402 HARTMAN RD
City: FORTPIERCE State: FL
Zip: 34947 Phone: 77Z224-9926
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
x Not Applicable
MORTGAGE COMPANY: x Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name: _
Address:
Zip: Phone: I 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 contlict 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
commencine work or recordine vour Notice of Commencement.
r•
Signature o wner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF —1 J I l.0
The Going instru entin _ was,�ckn e20 ¢�efore me
this II dayof�( '� 20 Eby
Rj�)6+ lIktldms
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known �OR Produced Identification
Type of Identification Produced
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was a knowledged before me
thisday of 20 Lby
i2�.f�— Vv i 1 �1 Q/i1s
(Name of person acknowledging)
�VPf,A-
(Signature of Notary Publ - State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No.il +'o DAWK +� cM I� I Commission No.
:: : ..vrnuuW #GG162348
Revised 07/
qmRnZGERALD
MY COMMISSION # GG 182348
EXPIRES: December 17.2021
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REV
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
ni 31 I