HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: % SCANNED Permit Number: �y
BY
St. Lucie County RECEIVED
Building Permit Application MAY 0 2 Z019
Planning and Development Services
Building and -Code -Regulation Division
1300 Virginia Avenue, Fort Pierce FL 34981
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT APPLICATION FOR: Boaklift
Address: 103 QUEENS RD. FT PIERCE, FL 34949
Legal Description: QUEENS COVE - UNIT THREE- BLK 25 LOT 11
Property Tax ID #: 1423-602-0011-000-0
Site Plan Name: MATULA - HOWELL
Project Name: MATULA- HOWELL
Setbacks Front Back: _
Right Side: Left Side:
ST. Lucie County, Permitting
Residential X
Lot No.
Block No.
11 DETAILED DESCRIPTION OF WORK; III
FURNISH AND INSTALL 1 PC. 24,000 LB. BOATLIFT
CONSTRUCTION INFORMATION:
hiHVAC I_JGas Tank GasPiping LJShutters
Electric 0 Plumbing E]Sprinklers Generator
Total Sq. Ft of Construction: S Ft, of First Floor:
Cost of Construction: 2,400.00 Utilities: Sewer Septic
❑Windows/Doors
11 Roof = Roof pitch
Building Height:
OWNER/LESSEE: CONTACT- RICK HOWELL
CONTRACTOR:
Name MATULA, SANDRA ( CONTACT RICK HOWELL)
Name: ROBERT WILLIAMS
Address:103 QUEENS RD
Company: WILCO CONSTRUCTION INC
City: FT PIERCE State: FL
Zip Code: 34949 Fax: NIA
Phone No.772-302-0435
Address: 10751 ORANGE AVE
City: FORT PIERCE State: FL
Zip Code: 34945 Fax: 772460-6929
Phone No. 772-460-6928
E-Mall: 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 $250D or more, a RECORDED Notice
is requires.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION '111
Name: DANIEL PAUL RETHERFORD
Address: 1402 HARTMAN RD
City: FORTPIERCE State: FL
Zip: 34947 Phone: 772-224-9826
SIMPLE TITLE HOLDER: X Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
X Not Applicable
Address:
City:
Zip: Phone:
State:
BONDING COMPANY:
Name:
_Not Applicable
Address:
City:
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 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
commencine work or recording your Notice of Commencement.
Signature of Owner/Lessee/C trac gent for Owner
STATE OF FLORIDAs_�
COUNTY OF L {�
The for oing instru e t as acknowledgebefore me
this c]day of 20 by
(Name of person acknowledging)
(Signature of Notary` Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Prod
DAWN
Commission No.
._.. .� cvoIRES:Oecember17,2425 1i;
Revised 07/
s
Signature of Contraetcir70cense Holder
STATE OF FLORIDA
COUNTY OF. I A CA —
The forgoing instrument was acknowledged before me
this day of 20 jg_ by
Glace
(Nime of person acknowledging)
(Sigriature of Notary ublic-State of Florida )
Personally Known __1Z0R Produced Identification
Type of Identification Produced
Commission No.
WCOMMISSIONf{GG 162348
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