HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: lliZZ2 :7zc 7- � Permit Number:
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a
Building. Permit Application
Planning and'DevelopmentServices
Building and Code Regulation Division Commercial 1t�— Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: J �k !� / Tit
PROPOSED IMPROVEMENT LOCATION:S1ua�C4,�J pi'1'1�NiGc��
Address: �1 tlt7� Q OC ,r l Dr. P tt-1 o , s.J:e riS,e q 2L,1� 3ql' 2�
Property Tax ID' #: Lot No.
Site Plan Name:
Project Name: _
Block No.
I DETAILED DESCRIPTIONDF WORK:
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors _ Pond
_ Electric gPlumbing r Sprinklers _ Generator _ Roof Pitch
Total.Sq. Ft of Construction:
Cost of Construction: $ la
Sq. Ft. of First -Floor:
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name 4
Name: Justin Thiery
Address S -w
Company:_. Island KitrhPn R Rath
City442,e (,-f Stater
Address: 10875 S Ocean Drive
Zip Code: �CjC�"� Fax:
City: Jensen Beach State: FL
Phone No. - L� - ;�-31-7 _ r I
Zip Code: 34957 Fax:
E-Mail: !ice- DI". a BS/S��f �Q�i►1 !� 6
Phone No 772-237-7348
Fill in fee simple Title Holder on next page ( if different
E-Mail ikb.nm-assistant gmail rnm
from the Owner listed above)
State or County License CBC1259508
-of, WI IiN MYNYI� ,� �.,� .,, ,,,u,v, d. R�uunuzu nouce or commencement is requireo.
If value of HAVC is $7,500 or more, a is
Notice of Commencement Is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: — Not Applicable
Name:
Address:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
City:
Zip: Phone:
OWNER/ CnNTRAr"rnR Aeeinvir. A__„__.:
- - - • r,NN„6ouv1: 1� irereuy mace to ootarn 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, wails, 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before th f t
with lender or an attorneybefore commencingwork
ou intend to obtain financing,
orlr�ecording seMon.Iourr Notice of Commencement. consult
Signature of Ow er/ Lessee/Contractor as Agent for Owner
ct
re of Contraor/License Holder
iSTE
STATE OF FLORIDA
-,
OF FLORIDA
COUNTY OF ,� J� < <
COUNTY OF St Lucie
Sworn to (or affirmed) and subscribed before me of
Ph sical Presence
Sworn to (or affirmed) and subscribed before me of
__LD or Online Notarization
this day of r"�� -iy : �o�, 20^%C by
Physical Presence or Online Notarization
this day of 0c-t'0/A&' 20;40 by
Justin Thi .ri
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known X OR Produced Identification
Type of Identifikcation
Produced i5l`
Type of Identification
Produced
RAAZ
(Signs r Nota ublic-Flo ' ssion#GG318
(Signature of u ic- St of Florida )
' xp'irIes July 28, 2023
on No. �` gB�eodoaN'owrysorvkos
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FOf ``�� oo
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C m �¢ ( MICHAEL RAAZ
.. ry omrnlaslon # GG 318620
o� Explres Jul 2
REVIEWS FRONT ZONING SUPERVISOR
or F Bonded ru Budget Notary Servkc
PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.