HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED n (�
Date: rG Permit Number: �11 XU
• _ SCANNED
Building Permit Application BY
t° C
Lucie County
Planning and Development5ervices St. •y
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 _
--Phone: (772) 462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Dock and Boat Lift Piles Only III
,,.,,,
Adds,,- 10701 S OCEAN DR LOT 928 JENSEN BEACH, FL 34957
Legal Description: VENTURE OUT AT INDIAN RIVER INC LOT 928
Property Tax ID #: 4511-510-0128-000-0 Lot No.
Site Plan Name: PARVIN Block No.
Project Name: PARVIN - DOCK and Boat Lift Piles Only
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION .OF WORK;
1. FURNISH AND INSTALL 260 SQ FT. +/- DOCK
2. FURNISH AND INSTALL BOAT LIFT PILES ONLY
CONSTRUCTION, INFORMATION; = �I
HVAC LJ Gas Tank
Electric 1:1 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 10,000.00
iva—u,c'n au
aNpry.
❑
Piping
_Shutters
Windows/Doors
nklers
1 Generator 1:1
Roof = Roof pitch
Sq. Ft. of First Floor:
Utilities: 0 Sewer E]Septic
Building Height:
O.W N ERAESSEE`.
CONTRACTOR;
Name PARVIN, GLENN & LINDA
Name: ROBERT WILLIAMS
Address: 8415 BRIDGE RD
Company: WILCO CONSTRUCTION INC
City: GROSSELLS State: MI
Zip Code: 48138 Fax: NIA
Phone No.313-215-6269
Address: 10751 ORANGEAVE
City: FORT PIERCE State: FL
Zip Code: 34945 Fax: 772-460-6929
Phone No. 772-460-6928
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 $2500 or more, a RECORDED Nonce of commencement is regwreo.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable
Name: DANIEL PAUL RETHERFCRD
Address: 1402 HARTMAN RD
City: FORTPIERCE State: FL
Zip: 34947 Phone: 772-224-9826
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: x Not Applicable
Name: _
Address:
City:
Zip:
Phone:
BONDING COMPANY: _Not Applicable
Name: _
Address:
City:_
Zip:
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 recording vour Notice of Commencement.
Signature'of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA � , 1 .
COUNTY OF (�,
The for�r oing instrument was acknowledged before me
this 1 day of 23 20 Aby
/ s
Signature of Contractor/License Holder
STATE OF FLORIDA&
COUNTY OF
The forgoing instrument was acknowledged before me
7 this _q day of e 20 gby
_ A- I4[1'1 Jin1� Rom— V1 i 111 am
(Name of person acknowledging) (Name of person acknowledging)
Ct (JLQJL- l j �
(Signature of Notary P lic- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No.
MYCOMMISSIDN#GG 162348
'y:P.Pt',` Bonded
Revised 07/15/201
(Signature of Notary Public- Slate of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No.
MY COMMISSION # GG 182348
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS ,