HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED cs
Date:l Ia Permit Number: VIO)-0151
RECE)`.'-.:D JAN 12 2J17
SCANNED
Building Permit Application BY
Planning and Development Services St. Lucie County
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/Seawall
e
Address: 5167 N. A1A
Legal Description: PLAT OF AVALON PARK (OR 3341-1263)
Property Tax I D #: 1410-501-0021-000-3
Site Plan Name:
Project Name:
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
CONSTRUCT A 40' +/- X 6' RAMP WITH A 12' X 20' DECK.
N'IN
ON:
Lot No.
Block No.
onai worrc to oe
HW
errorrneu
_
Gas Tank
unaer u115 Perrnu—cnecrc au
❑Gas Piping
_Shutters
apply:
❑ Windows/Doors
Electric
0
Plumbing
❑Sprinklers
1:1
Generator
Roof
Total Sq. Ft of Construction:
v
Cost of Construction: $
S Ft. of First Floor: _
Utilities:ll Sewer D Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR'
Name
Name: JOY SUMMERLIN
Address:5167 N. A1A
Company: SUMMERLINS MARINE CONSTRUCTION
City: FORT PIERCE State:FL
ZipCode:'34949-- Fax:
Phone No.772-794-6195
Address: 200 NACO ROAD
City: FORT PIERCE State: FL
Zip Code: 34946 Fax: (772)464-7470
Phone No. (772)464-6090
E-Mail:juliet@elliottmerrill.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: SUMMERLINSMARINECONSTRUCTION@GMAIL.COM
State or County License: 24217
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTALCONSTRUCTIONLIEN LAWdNFORMATION :
DESIGNER/ENGINEER: _
Name: BDHUTCHINSON
Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Add tress: 2705 S. INDIAN RIVER DRIVE
Address:
City: FORT PIERCE
Zip: 34950 Phone: (M)267.13ee
State: FL
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
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
DAB-
Signature of Owner/ A t/ Lessee Signature o ontraftor/License Hold r
STATE OF FLORID --I— (n� STATE OF FLORIDA
COUNTY OF Qa r COUNTY OF S+ Lu C j -Q--
The f riming instru ent was acknowledged before me The forgoing instrument was acknowledged before me
this � day ofP 20 � by this day of SCU �UQ f i 20__In by
<Re�� E-,
(N_ne of person acknowledging)"
(Sign fyre of Notary /Public- State of Florida )
Personally Known V/OR Produced Identification
Type of Identificatio _„
Commission No.
Revised 07/15/2014
MY COM1(111e$4I0N #FF132752
EXPIRES September 28, 2018
v �,
(Name of erson ackno ledging )
�>dA'q .I2A . P
(Signature of N tary Public -State of Florida )
Personally Known _Z_ OR Produced Identification
Type of Identification Produced
Commission No.
P NESTER
MY COMMISSION # FFDM
EXPIRES Auguet 2s, 2078
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
��
INITIALS