HomeMy WebLinkAboutStegeman Permit Application_000006All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I'I �Dh_ Permit Number:
Building. Permit Application
Planning and'DevelopmentServices
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:-��(Q� 1 La -
PROPOSED IMPROVEMENT LOCATION:
Address:C-> S C's Por, 1)r �"
Property Tax ID#:'AC5Va - �Q0\ -0\Ua - C.UC_-,0 -3 Lot No.
Site Plan Name:
Project Name: _
Block No.
DETAILED DESCRIPTION OF WORK: --D _ — S _ . ^I- , . r" „ a4 .,
1=L
New Electrical Meter
Second Electrical Meter
I CONSTRUCTION INFORMATION: I
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gr�as Tank __ Gas Piping _ Shutters
�ectric VPlumbing __Sprinklers
Total.Sq. Ft of Construction:
Cost of Construction: $ �Hoc>
Generator
Sq. Ft. of First Floor:
Windows/Doors _ Pond
Roof Pitch
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name 'A
Address:c`l
t
Name: Justin Thiery
Company: Island Kitchen & Bath
Address: 10875 S Ocean Drive
City: Jensen Beach State: FL
Zip Code: 34957 Fax:
Phone No 772-237-7348
city:1knSeV--N •Stater
Zip Code: 3-A!S---- Fax:
Phone No. 94J� --tea _ uaa
E -Mail: Y11C_
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail rom
State or County License GBC1259508
If value of construction is 2500 or more, a. RECORDED Notice of Commencement is requirea.
If value of HAVC is $7,500 or more, a RECORDED 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:
City:
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 thepermit 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 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 the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing work or rewrdinR your Notice of Commencement.
ev.
Signatur of Owner Les a/Contractor as Agent for Owner
Si re of Contractor nse Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF 5". Ll n..P,rme-
COUNTY OF St Lucie
Sworn to (or affirmed) and subscribed before me of
Sworri.to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
✓Physical Presence or Online Notarization
_,,/_
this* day of . n a)rj_ ..b,t,✓ 20aU by
this day of f ld�lAn iyc,r 20,:;)0 by
U V\68
Justin Thiery
Name of person making statement.
Name of person making state ent.
Personally Known OR Produced Identification
Personally Known X OR Produ$gq identification
��r,
Type of Identification
Type of Identification MICHAEL � .••••.,
Produced o� .° MICHAEL RAAZ
produced r+ , k Commisslon # GG 3186
Commlaslon # GG 318620
" rr \oma Expires July 28, 2023
"y \oma Expires July 28, 2023
cr r �P 3onded Thru Budget Notary Seel
(Signature of Not Public - State of Flori a)
(Signature of Nota is ate of Florida )
Comm' o o. (Seal)
Commo (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.