HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCER' cu n
Date: J=o_�� Permit Number: - I yl
�Qb% SCANNED
�._,_
St. Lucie Countymoo Building Permit ApplicationF—RECEIV7ED
JUN 06
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT APPLICATION FOR: Dock/Seawall
ST. Lucie County,
Residential X
IPROPOSED IMPROVEMENTLOCATION- ry I
Address: 3058 NW RADCLIFFE WAY
Legal Description: RIVERBEND (PB 67-36)- LOT 16
Property Tax ID #: 4425-703-0021-000-8
Site Plan Name: RIVERBEND
Project Name: DUERSTEN DOCK
Setbacks Front Back:
Right Side: Left Side:
Lot No.16
Block No.
DETAILED DESCRIPTION OF'WORK:
CONSTRUCT A 140' X 4' ACCESS PIER, A 160 SQ FT TERMINUS AND 1 BOAT LIFT
CONSTRUCTION INFORMATIQN s a
AMMitinno wnnnrr to hnartnr�H=r this nnrm if r o n I I !� n.......
LJHVAC "Gas Tank UGasPiping L jShutters
Electric 0 Plumbing []Sprint
Total Sq. Ft of Construction:
Cost of Construction: $
:rs FIGenerator
S Ft. of First Floor: _
Utilities:Sewer Septic
Windows/Doors
11 Roof = Roof pitch
Building Height:
OWNER/LESSEE:
GONTRACTOa:
Name ROBERT DUERSTEN
Name:
6
Address: 3058 NW RADCLIFFE WAY
Company: TREASURE COAST BARGE, INC
City: PALM CITY State: FL
Zip Code: 34990 Fax:
Phone No. 866-531-3848
Address: 1200 SE CUTOFF ROAD
City: STUART State: FL
Zip Code: 34994 Fax:
Phone No. 772-201-9777
E-Mail: rob@marklanding.com
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 $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
Name: PAUL WELCH. INC
Address: 1984 BILTMORE DR #114
City: PORT ST LUCIE State: FL
Zip: 34982 Phone 772-785-9888
FEE SIMPLE TITLE HOLDER: _ Not Applicable .
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
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 orzecordirlsvour Notice of Commencement.
< ; V`IG+6 d io
Signatur of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contra r/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF (\ A_A)4
COUNTY OF
The f rgoing instrumeq(twas 'ac'knowlecig before me
this day of / 20 by
The f rggiu instrument wa, acknowledg efore me
this day of 200JJ by
1 1 l l
pL_
� l_L/t l k i� CQ
Name of person making statement
Name of p r making statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Produced IFO L_�
Type of Identification
Produced
(Signat Ire of Notary Public- State of Florida)
Si nature
of No ary
_
Commission No. (S Ij> fiCaI11t1RN,
u Notery PubllgS
; '.<+ �.,, LUCYJULIANO
.''t Notary Publ'{r��$tppt��of Florida
nNo. commisskni@-Gi1A01693
tAPUii
tS5iry1611i 1
COmmISS10M1i:
Mycomm.expr
P928A44
OCt.18,2019
'-:°>'m--�; My Comm.Ex�IesAug 30.2021
r.:?•' or: th¢Li,Natic•aIM1:L7A$$,.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW.
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17