HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONs
ALLAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
SCANNED
BY
Building Permit Applicationst. Lucie county
Services Npv 1A IM
Planning and Development
Building and Code Regulation Division Department
permi�n9
2300 Virginia Avenue, Fort Pierce FL 34982 ct 100P county
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Dock/0
PROPOSED IMPROVEMENT LOCATION:
Address: 3054 NW Radcliffe Way
Legal Description: RIVERBEND (PB 67-36)- LOT 15
Property Tax ID fi: 4425-703-0020-000-1 Lot No. 15
Site Plan Name: RIVERBEND Block No.
Project Name: THEODOROPOULOS DOCK
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCT A 149' X 4' ACESS PIER; A 10'���QQ16' TER INUS; INSTALL A JET SKI LIFT AND 4 PILES FOR FUTURE
CRADLE LIFT�� Cam`
CONSTRUCTION INFORMATION:
Additional work to be erformed under this permit —check all that apply:
11HVAC E] Gas Tank []Gas Piping ❑ Shutters ❑ Windows/Doors
®Electric 0 Plumbing ❑ Sprinklers ❑ Generator ❑ Roof ❑ Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: 75 Z • 0 b Utilities: []Sewer ❑ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name PETER & ELAINE THEODOROPOULOS
Name: LISA JULIANO
Address: 3054 NW RADCLIFFE WAY
Company: TREASURE COAST BARGE, INC
City: PALM CITY State: FL
Address: 1200 SE CUTOFF ROAD
City: STUART State: FL
Zip Code: 34990 Fax:
Phone No. 561-523-1358
Zip Code: 34994 Fax:
E-Mail: elenitheo@aol.com
Phone No. 772-201-9777
Fill in fee simple Title Holder on next page ( if different
E-Mail: JERNER@BELLSOUTH.NET
State or County License: 20077
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: PAUL WELCH, INC
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address: 1984 BILTMORE DR #114
Address:
City: PORT ST LUCIE State: FL
Zip: 34982 Phone 8
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY:
Name:
_Not Applicable
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 1 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
commenrine work nr recordine vour Notice of Commencement.
�C�e� d-fuR:CYfSZ5�4�7
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Signature of Owner/ Lessee/Contracttlr as Agent for6winer
Signature of Contractdfr/License Holder
STATE OF FLORIDA ` `
STATE OF FLORIDA yl p Qn
COUNTY OF h��n
COUNTY OF Ill`
The forgoing instrqment was acknowledged before me
this �Lday __ NS y'Zrr&-J2fi.201a by
The forgoing instru ent waF acknowledged before me
this of i 20 by
Iljn e I Yl Q oFC PC�f L9S
I_,[2_day \11 `��
I—� °� Q . LRh t Ot Yl O
Name of person making sta ement
Name of person making statement
I_V—
Personally Known OR Produced Identification V/
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced I 1 c2.ns o,
Produced
,1yv UCIA CRSTOFORO
LUCIA CRISTOFORO ':°� Notary Public • State of FI
r'
Notary Public - State of Florida
< Commission # GG 2792
<.
16� commission p GG 219263 d' M Comm. Expires May 17(Signature
ftaidff
of Nota Public- 'n'd,Ny amm. pues a ?0nature of Notary blic- Stat f Florift ed through Nat ono ota/s 8eN through National NotaAss .
//��CommissionNo.(l�2liQ2Seal ,Commission No. Gilt7-192- 3 (Seal)
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Rev. 8/2/17