HomeMy WebLinkAboutBuilding Permfit ApplicationALL 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: Window/door
c.
Address: 10000 C)n ✓:t (.l r1 tT
Legal Description:
Property Tax ID #: 4SZ4�'^ '?ol W'> d' GY.b- Lot No.
Site Plan Name: (�/IP,IL.I•t� Block No.
Project Name: L0L4VjC0\AD Pro �r
Setbacks Front Back: Right Side: Left Side:
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Additional wor toe nerformed un er t is permit- Check a apply:
HVAC Gas Tank []Gas Piping Shutters Q Windows/Doors
11 Electric 1:1 Plumbing Sprinklers E Generator F� Roof Roof pitch
Total Sq. Ft of Construction: , I S Ft. of First Floor:
Cost of Construction: $ c� co L- • 00 Utilities:cn Sewer Septic Building Height:
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Name 0.%LC� (�A�
Name: Justin Thiery
Company: Island Kitchen and Bath
Address: [DODO S Oc t_a-^ QV-( :e_, l o('o
City: � 1 State: 02—�
Address: 10875 S. Ocean Drive
City: Jensen Beach State: FL
Zip Code: Fax:
Phone No. (y (d-• a0T- C) (-
Zip Code: 34957 Fax:
Phone No. 772-678-8219 - 772-237-7348
E -Mail: jthieryikb@gmail.com; nblaszkaikb@gmail.com
—
E -Mail: c.(rtu"JLL�-Dcsr�C"4-C4'ygn
_
Fill in fee simple Title Holder on next page ( if different
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.
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
com encing work or recordinR vQur Notice of Commenceme
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DESIGNER/ENGINEER:
Name:
_ Not Applicable
ATE OF FLORIDA
MORTGAGE COMPANY:
N am e: J ustin Thiery
_ Not Applicable
Address:
The forgoing instrument was acknowledged before me
this day of I`f1d.v20 o by
Address:
((^^` (�,,—
-d_k
City:
Zip: Phone
State:
Name of person making statement
City: Jensen Beach
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
— Not Applicable
Produced Drivers License
BONDING COMPANY:
Name:
Not Applicable
Address: 10875 S. ocean Drive
(Sig ature of N Publ' State of Florida)
of rida )
(Signature of Pubic�rnle
Address:
Co ission No. *L►ZgAz
City:
Zip: Phone:
+ Commisslon # GG 31862
dor F�oP WOW Tiru 84col Notary Smicos
City:
REVIEWS
Zip: Phone:
ZONING
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
com encing work or recordinR vQur Notice of Commenceme
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ig a of c c r/Li ense Holder
Signature of Owner!-Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
ATE OF FLORIDA
COUNTY OF St Lucie
COUNTY OF St. Lucie
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of I`f1d.v20 o by
this Qa day of �10-r c/L , 26c
((^^` (�,,—
-d_k
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 ature of N Publ' State of Florida)
of rida )
(Signature of Pubic�rnle
Y
Comm' ton ?�`;A���. CH LRAAZ
CoAW#GG 318620
Co ission No. *L►ZgAz
�,+At Expires July 28, 2023
+ Commisslon # GG 31862
dor F�oP WOW Tiru 84col Notary Smicos
Expires Jul
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
mNft ��aa� ..0
SEA TURTLE MAftbVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17