HomeMy WebLinkAboutBuilding Permit 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 Commercial X Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Island Kitchen & Bath
PROPOSED IMPROVEMENT LOCATION:
Address:C�A"S�J (X` U c".� VI)V— i to o 5 a -
Property Tax ID #:
Site Plan Name:
Project Name:
- lsPb t - r�> 1--4,4 _ -
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Lot No.
Block No.
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
(yeElectriclumbing _Sprinklers _ Generator — Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cost of Construction: $ {_(4 - C, �I . UD Utilities: _ Sewer _ Septic
Name
Zip . • 3�,
Phone. Qr:•r
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Building Height:
CONTRACTOR: K
Name: Justin Thiery
Company: Island Kitchen & Batyh
Address: 10875 S Ocean Drive
City: Jensen Beach State: FI
Zip Code: 34957 Fax:
Phone No 772-237-7348
E-Mail ikb.pm.assistant@gmail.com
State or County License CBC1259508
n VQIUC Vl 6VIIDUY{.LIUII is cauu or more, a KtLUKutU Notice of commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
'��5�Nil�ES .,. -
:.µ
, �
.aa,,, . , 3, ,. � ,A ., t.,,,,.F; ^'; a fig.
DESIGNER/ENGINEER: Not Applicable
`�%'� b� �m�.�.' a t� � 7,�'x
.,.::;: .....: ✓ ,;"'ih�- �� .... �' .
_
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:
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 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 r ordin our Notic of Commencement.
Corn
U
Signature o 0 ner/ Lessee/Contractor as Agent for Owner
gna ure of Contr nse
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OFJ�—r ,(,-e
COUNTY OF St Luciee
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
is A, day of M&An202f by
X hysical Presence or Online Notarization
,
this day of J��,�-�Q.L, 202 f by
Justin Thiery
Name of person making statement.
Name of person making statement.
Personally Known —,.—,/OR Produced Identification
Personally Known X OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
% --
/
(Signat ary Public] ' ,Pf Flori
Commission # GG 318620
(Signature of�J�, is Offj;�r
' c� Jul 28, 2023
Commission No. et �V'g y
rFapp�a�� Bondedihru udgelNotarySenfcos
, Commission # GG 1862Q
Commission NO. a 6SdUly28,YQZJ 11
FOF Flo Blinded ihru Budget Notary Services
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.