HomeMy WebLinkAboutBuidling PermitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
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 Residential X
PERMIT APPLICATION FOR: Renovation �I
Address:��xj�
Legal Description: �S�GrI/;G• l�(1XlG�0Yyl►Y�,`. ,ter, �,�,I,.;t�i IaboZ,
Property Tax ID#: 4'-Ua UU" Lot No.
Site Plan Name: - hAAdC2N2, _e(C. Block No.
Project Named 1`-t-,AQIn ,AC
Setbacks Front Back: Right Side: Left Side:
, � l�'l �-I�[��s ��--rt , �u. �s r ��-i-G� �.-c-�►'��,..� �(� �t x�-(.«.,c� t c.�i� c �
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Additional work oe e orme under this permit -check a appy:
11
HVAC Gas Tank Gas Piping 11 Shutters Windows/Doors
Electric E;_P F]Sprinklers M Generator F-1 Roof Roof
_ umbing pitch
Total Sq. Ft of Construction: Sq.of First Floor:
F-]
Cost of Construction: $ 18 Utilities: !-1 Sewer Septic Building Height:
P'.. a r..
Name �� Name: Justin Thiery
Address y (-) U S uv1-� 1D-68 Company: Island Kitchen and Bath
City')�� ze'-� State: IEa Address: 10875 S. Ocean Drive
Zip Code:,"AC*�;i' Fax: City: Jensen Beach State: FL
Phone No._,:)(74- - UK V1 Zip Code: 34957 Fax:
E -Mail: -_ Phone No. 772-678-8219 - 772-237-7348
Fill in fee simple Title Holder on next page ( if different E -Mail: ithieryikb@gmail.com; nblaszkaikb@gmail.com
from the Owner listed above) i State or County License: CBC1259508
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address: 10875 S. Ocean Drive
City:
Zip: Phone:_
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name: Justin Thiery
Address:
City: Jensen Beach 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 ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules bylaws or anscovenants 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 or recording your Notice of Commencement.
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Sigdature of Owner/ L see/Co tractor as Agent for Owner
Sig t o 66PContractor/License Holder
STATE OF FLORIDA
STkTE OF FLORIDA
COUNTY OF St L.60
COUNTY OF-- Lud.
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
thil�' ay of20_-V_.> by
this°ViA& day of 2iiaf) by
SA"10rr1 l7 "C. '^ ,=CAS-.
Justin Thiery
Name of person making statement
Name of person making statement
Personally Known OR Produced Identification x
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced Drivers License
Produced
(Sig"Notaate of Florida)
(Signature of Nota - tat of FloridaMICHAELRAAZ
MICHAELRAAZ
ComCommiss(�(jG318620
Commiss' No. * Comml�iieei#�GG31R620
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17