HomeMy WebLinkAboutBuilding Permit Application am
ALL APPLICABLEINFO'MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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P.erniit Number:
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Planninganda pplrcatiion
Development services
Building.and Code Regulation Division
-2300 Virginia.Avenue,:i=ort Pierce FL 34982
Phone:(772)4624553 fax:(772)462-15.78 CO[nmercial
Residential x
PEWIT APPLICATION ICATION FOR:.
Renovation.
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Legal Description.:_• I ��� p!� Yl Lc'SS Qt -:
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Propertv.Tax iD#:-
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Site Plan Name: UU JL1 �i1 Lot.No;
Slock'No.
Project Name; d
Setbacks Front ..
Back: ;Rlght'Side:.— left Side:
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ona warto ate armsa uncler this permit c ec a a
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0HVAC s Tank ❑Gas Piping Shutters
a WindowsJDoors
RElectric LJ..Plumbing S rinklers
p Generator Roof.
Total Sq.Ft bf'Construction:
S ..Ft.of.First>loor:
Cost of.Construction:$ Cj�
Utilities: Sewer Septic Buiiding'Height:
t�UNfR/ Ei4 t31�iT,RACTOR. ,
Name l A Name: Justin Thieiy
Address:
q• . .t°i .?i0 Company:. Island Kitchen&Bath
City;: State:.FL Address::2340-5E Chadeston`Dr.
Zip Code: 3 5"1 Fax: 1 Gi City: Port St i ucle to FL
5ta .phone No: 1 2 Z - "I 3 $ .. 34 52.
Zip Code: 'Fax:.
E MaiL_ V1 16L Phone No. (772)678-8219..
Fill in fee simple Title Holder ory next page(If different E-Mail: jthleryikb�a gmail:cnrn
froni•the Owner listed above) C8C1269508:
State.or County License;
!f value of constructiori:is$2500 ormore,a RECORDED Notice.of Cdinmencementts required,
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DESIGNER ENGINEER:` Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State; City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name: -
Address: Address:
City: City,;
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a&rmlt.
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 wl11,in all respects,perform the work
in accordance smith 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
improvemePts.to your property.A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection, if you intend to obtalln financing,consult with lender or an attorney before
commencing work or recording.ypur Notice of Comm enceme .
C
4 ig ure of Owner/Agent/Lessee i a re of on ractor/License Holder
STATE OF FLORIDA 5T TE OF FLORIDA
COUNTY OF.LLwW COUNTY
The for oing instr ent was acknowledged before me The rgoing instr ent was acknowledged before me.
this day of 20� by this�day of_.I? _j ,20 by
,1 Justin Th"tory
(Name of person ackno d ' -(Name of person acknowledging)
(Signature otary Pubi ate of Florida) (Signature of Notary Public-Stat rida}
P socially n OR Pgyoyced 1 entification Personally Known.x roduced identification,—
T entification Product WC- 0 L_MICH Type of idced._,
Y COMMISSION#FF 904140 �L}— �a�a...z% {SeaIIIICHAEI RAAZ
Commission No Fl=1 D 4�� �* (TORES:July 28,2019 Commission ZrNo. DIY COMMISSION#FF 904140
)/+� ">FOFrtio�`O BondedThruBudgetNotaryServices Y� '�
EXPIRES;Jui 28
orr�o� on ad I nru Budget Notary Services
Revised 0711512014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW"
COMPLETE
DATE-
INlTiALS