HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEkEU
Date: /°� �D') 3; Permit Number: I o�'�'' b• ��r'f
7 -RECEIVED
'Building Permit Application DEC 2 0 2018
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue, Fort Pierce FL 34982 t .L i e County; FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial R
PERMIT APPLICATION FOR: Boat lift
PROPOSED IMPROVEMENT LOCATION:
Address: HARBOUR RIDGE-BLVD SLIP #61/ (OWNER ADDRESS) 12790,NW MARINER CT
Legal Description: (MARINA) HARBOUR RIDGE -PLAT 3-TRACT PA-4(2.16 AC) (OR 714-219:1361=1125)
(OWNER) MARINER VILLAGE HARBOUR RIDGE -PLAT 4= UNIT_24
Property Tax ID #: ( ARINQ)<142502=0007_OOQ4 / (OWNER)4425 603 0036-000-9 Clv Lot No., -
Site Plan Name: lock No.
Project Name: WITACZACKSLIP#61 BOAT.LIFS , C0 ,
Setbacks Front' Back: Righf Side: Left Side:
DETAILED DESCRIPTION OF WORK:
INSTALL A BOAT LIFT WITHIN SLIP# 61 HARBOUR RIDGE MARINA'
CONSTRUCTION INFORMATION:
Gas Tank -
Plumbing
Total Sq. Ft of Constructio :
Cost of Construction: $
is Piping I AShutters
ors - Generator
S Ft. of First Floor: -
Utilities:Sewer � Septic
Windows/Doors
Roof F• Roof pitch
Building,Height:
OWNER/LESSEE:
CONTRACTOR:
Name MARK WITACZACK
Name:
Address:12970 NW MARINER COURT
Company: TREASURE COAST BARGE, INC
City: PALM CITY — State: FL
Zip Code: - , 34990. ,Fax:
Phone No. 913-991-2400
-Address: 1200 SE CUTOFF ROAD
City: , STUART State: FL
Zip Code: ' 34994 '' Fax:"'
Phone No. 772-201-9777
E-Mail: MWIT@CABLEONE.NET
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: JERNER@BELLSOUTH.NET
State or County License: 20077
If value of construction is $ZS00 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTR ON LIEN LAW INFORMATION: ,
DESIGN R/ENGINEER: X Not Applicable
MORTGAGE COMPANY: _ Not Ap icable
Name:
Name:
Address: §''.
Address:
City: State:
City: State: j
Zip: Phone
Zip: Phone:
4
FEE SIMPLE TITLE OLDER: ,, Not Applicable
BONDING COMPANY: _Not Applicable
_
Name: `"
Name:
Address:
Address:
City:
City:
Zip: Phone.
Zip: Ph e:
OWNER/ CONTRACTOR AFFI VIT: Application is hereby made to obtain a per it to do the work and installation as indicated.
I certify that no work or installation\FFI
enced prior to the issuance of a per t.
St. Lucie County makes no representt is granting a permit will authori the permit holder to build the -subject structure
which is in conflict with any applicabOwners Association rules, byla or and covenants that may restrict or prohibit such
structure. Please consult with your Hers Association and review y r deed for any restrictions whlch:may apply.
In consideration of the granting of thed permit, I do hereby agr a that I will, in all respects, perform the work
in accordance with the approved plaida Building Codes and . Lucie CountyAmendments.The following building permit applicaex ptfromunderg ng a full concurrency review: room additions,
accessory structures, swimming poo, wal signs, screen ooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record
improvements to your property. A Notice of
before the first inspection. If you intend to obt
rnmmpnrinv wnrk nr mcnrding vour Notice of
Commencement may result in your paying twice for
ment must be recorded and posted on the jobsite
:ing, consult with lender or an attorney before
Signature of Owner/ Lessee/Contractor, as Ag t for Owner -
ignature of Contractor/License Holder
STATE OF FLORIDA
ORIDA
S\_y
COUNTY OF
C
The forgoing instrument was acknow dged before me
Ttrument was acknowledged before me
this _ day of 20_ by
t20_ by
Name of person mak' g statement
'Name person making statement
Personally Known Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identificatio
Produced
Produced
(Signature of Nota Public- State of Florida J
(Signature of Notary Public- S to of Florida )
Commission No. (Seal)
Commission No. (Seal)
REVIE
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTL
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW"
REVIEW
DAT
RECAIVED
D E
'
C MPLEfED
Rev.8/2/17 ��
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
�
MORTGAGE COMPANY: Not Applicable
Name: l"�DA2l lK_I
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEET 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 recordin our Notice of Commencement.
5�i
1
Signature of Owner/ Lessee/Contractor as Agent for Owner
Si ature of Contractor L1 rise Holder -
STATE OF FLORIDA
STATE OF FLO IIl4. ,D .i1�.
COUNTY OF MwrtL^
COUNTY OF Yr`ILI�T��
The forgoing instrument was acknowledged before me
The f rig ins e a ackn led d before me
this l4 Flay of rp e r e en h e f 20-a by
this day of 2 by
M(AtV< w%}ac2_2CLCW
l
Name of person making statement
Personally Known OR Produced Identification
Name of erson making statement
r nally Kn OR Produced Identification
Type of Identification
Typ lcation
Produced t7r,)er- 1-1Cen5e
Prod ed
re ota Public ril�defjn blic-6 ateofFlonda
tO�'^^A' t.u9 - '- cc miss GG 101693
�i ion No. "?_•_ 'B y$@a 0lresAO 30.
19 186 stl rp�, 9 2021
rout}NatlorolNolaryyN,
ar7, 2022
I otaryAssn.
(Signature of Notary Public- State of F
¢; BEN DEPALr
Commission No. G 61 a 3l S G Notary Public -6tat
-�y'�' Commission. GG
�.,. My Comm. ExpiresM1
" Bonded through National
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17