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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INM MUST BE COMPLETED FOR APPLICATION To BE ACCEPTED Date: Permit Number: k RECE E® planning'aitd Depe/opment-SerVices Building Permit Application MAR 0 .t 2017 Building and Code negulation Division PE R M ITTi NI G 2300 Virgin oAvenue,Fort pierce Ft 34982 St. Lucie County; FL Phone:(772)4624553 Fax:(772)462-1578 COrrtrnt'Ceia) -- Residential x PERMIT APPLICATION FOR: Renovation �PRt?P45�A� �lIPROI/ENlENT iOC�gT1�N Address: (7 S. 0 L�GLiil ✓7 F�. +- � ��� .:.. .�. P�vt s 6'V1 L 9 4-9 5 Legal Description: S:� 1/V i vI S CD Vi G1 O IM I!/t ILL vVi A +, ci Q 6 Property Tax lD � 9'- DD1D- p00-2 Site Plan Name..M Q-1- JL4&_1 f YVl a AA Lot No: Project Name: Jv1 at--M A,10 Bl©ck No. Setbacks Front Back; Right Side: left Side: ETT'AILI:C3 bSfiR16�TIC�N O!`WC�RiC k . �/ew e%�� � _�J ,.,b�` 's� New T " IO IW a aN ona wor o e e orrne un er is permit-check all app y �( `-„'H AC_ �C s Tank ( Gas Piping t_.1 p�ng Shutters ❑Windows/Doors - Electric L�►:pium* bin R OSprihklers Generator El Roof Total Sq:Ft crf Construction: 5 .Ft.of First Floor: Cost of Construction;.$ Utilities: Sewer Septic Building Height; *{#7=\ A TORf S Y Name: li G U yr iv I,GL f Name: Justin Thiery Address:i a 44 o(e a Vl a r Company: Island Kitchen&Bath City: c��iVl s/Ie� 6 r�(� -� state:FL Address: 2340 S Gharieston C7r: Zip:COde:. �t'��5.1 Fax:_h f a City: port St Lucie FL Phone No._( ��I Z�- Z��-�I 3 Stater 'Lip Code: 34952 Fax: E fvla it k S r-u C-h o v► -V)-jlifi-ffer, I'�G,1 I. Phone No, (772)tiZB 8295 Fill in:fee simple Title Holder on.next page( nt -Mail: ithieryikb@gmail:com from the Owner listed above) State or CountyLicense; QBC1269508 If value of construct ion is$2500 or more,a RECORDED Notice of Commencement is required. 777 DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY Not Applicable Name: Name: . Address: Address:' City: State: City: State.• Phone: Zip: Phone: PEE SiMPLE TITLE HOLDER: _ Not Applicable BONDING C4M_PANY: 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 permit. St.Lucie County makes no representation that is granting a permit will authorize the.permit holder to build the.subject 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,l do hereby agree that i will,in all respects,perform the work in accoedance.with the approved plans,the Florida Building Codes and St.Lucie County Amendments. Thefopowing: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 an, non-residential use WARNING T 3;oWNER,Your,failure to Record a Notice of Commencement may result in your.payaing twice for improvements'to your propefty.A Notice,of Commencement must be recorded and pasted on the Jobsite before th04irst inspection..If you intend to obtain financing,consult with lender or an attorney before commencing work or recording,your Notre of Commencernen Slgttattire of Owner/Agent/Lessee ure:.of Contractor Litense-hi er STATE OF FLORIDA S ATE OF FLORIDA CQVNTy.OF SLt,X COUNTY 4Fs=:cum The reoing instr ent was=ack6owiedged before me The forgoing,instr��l1ent was acknowledged before•me thli g clay of 20 .�'by this day of lei 20 -by Y.l�..C'Lyq��; JUs^h ThiCrY _ -- (Natne of.person acknowledging) (Name of person acknowledging) (Signature of Notary Putiiic rids} _ ' ature of Notary Pu e.of Florida) �~ eersonaNy.Kn OR Produced Identification V personals X OR Produced identification Type ofiidentifitatlon Produced ���y. Type of identification Producedar � � ____ } ` W e° , ., G� Comrritssion No, fit':R �� 140 MY '��510N#Fr 904146 MY CCU N#FF904 Commission No. Gj q (4 '� EXPrrtE�:SuIY 26 20'9 P, 4� B^ndxpThtdOudgetNotatyS Nice VFIiV:, Revised 0111 /2014 'REVIEWS FRONT ZONING• SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW" DATE: CAMPLETE INITIALS II