HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
�• �,�_ �� SCANNED Permit Number: 07 ��/�
Date: SCANNED
` St. Lucie FECEIVEDBuilding Permit ApplicatiJUL 23 2019
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
Permitting Department
RESrdeburale Caunty, FL
PERMIT APPLICATION FOR: Dock & Boat Lift 0 III
Address: 140 COMMONWEALTH CT
Legal Description: QUEENS COVE -UNIT 1- BLK 14 LOT M (OR 3532-658)
Property Tax ID #: 1414-701-0133-000-7
Site Plan Name: FORREST
Project Name: FORREST
Setbacks Front Back: -
IZETAILED DESCRIPTION OF WORK: _
1. Remove & Replace Dock
Right Side: Left Side:
2. Furnish and Install 1 pc. Boat Lift
Lot No.
Block No.
CONSTRUCTION INFORMATION: _ - III
C-IHVAC U Gas Tank
1-1 Electric 0 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 28,000.00
Piping _Shutters En]Windows/Doors
nklers 11 Generator Roof Roof pitch
_ S Ft. of First Floor:
Utilities:SewerEiSeptic Building Height:
OWNER/LESSEE:
CONTRACTOR: -
NameKENNETH M FORREST
Name: ROBERT WILLIAMS
Address: 144 VILLA DR
Company: WILCO CONSTRUCTION INC
City: POQUOSON State:VA
Zip Code: 23662 Fax:
Phone No.757-880-8660
Address: 10751 ORANGE AVE
City: FORT PIERCE State: FL
Zip Cade: 34945 Fax: 772460-6929
Phone No. 772460-6928
E-Mall:N/A
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 $2S00 or more, a RECORDED Notice or commencement is regmrea.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:. III
Name: DANIEL PAUL RETHERFORD
Address: 1402 HARTMAN RD
City: FORTMERCE State: FL
Zip: 34947 Phone: 772-224-9a2e
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name: _
Address:
City:
Zip:
MORTGAGE COMPANY: x Not Applicable
Name:
Address: _
City: State:
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.
Phone:
St. Lucie Count
yy 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
/J e
Signat re essee/Contractor as Agentfor Owner
STATE OF FLORIDA
COUNTYOF
The forgoing instrurrient was acknowledg d efore me
this J_ day of 114 20 by
kL ►idms
(Name
of�person acknowledging)
(Signature of Notary'I Public-Stateof Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No. .>' DAtBWPZGERALD
;.
MY COMMISSION H GG 182348
.. :.. i:c woocc. nemmAer 17.2021
Revised
c
S
Signature of Contractor/License Holder
STATE OF FLORIDA I .. �� J
COUNTY OF �I l_y.(
The forgoing instrum nt was acknowledged efore me
this _L clz . �(A � J 20 by
:aAaft nj,1,r
(Name of person acknowledging)
(Signature of Notary Public- State of Florida I
Personally Known_ OR Produced Identification
Type of Identification Produced
Commission No.
I if:;;•M••yar:.. DAWNFITZGERALD
2021
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS