HomeMy WebLinkAboutDonohue SLC Bldg Permit Application_000096All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3 `cR, s av 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: =.slw2� KA
PROPOSED IMPROVEMENT LOCATION: i
address: a4S_'S_e?") S Led 1 a ., c a , lh, e
Property �� ,�
Lot No.
Site Plan Name
Project Name:
DETAILED DESCRIPTION OF WORK: -I
e
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
.14lectric VIPlumbing _ Sprinklers Generator Roof Pitch
Total.Sq. Ft of Construction:
Cost of Construction: $ CMATn - __
Sq. Ft. of First'Floor:
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name: Justin ThierV
Address S
Company;_ island Kitchen & Bath
City: -State:.
Address: 10875 S Ocean Drive
Zip Code: S Fax:
City: Jensen Beach State: FL
fir+
Phone No. 7- 6754
Zip Code: 34957 Fax:
Phone No 772-237-7348
__
E-mail:QKSd i 1,gc,:a4_0 QL_o1.
E-Mail ikb.pm.assistant(!Zgmail cam
Fill in fee simple Title Bolder on next page ( if different
State or County License CBC1259508
from the Owner listed above)
it value of construction is 25UU or more, a. RECORDED Notice of Commencement is required.
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:
Address:
City:
Zip: Ph
State
FEE SIMPLE TITLE HOLDER: — Not Applicable
Name:
Address:
City:
Zip: Phone
ft SO-- I w
MORTGAGE COMPANY: ,r Not Applicable
Name:
Address:
City: State: _
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:_
Address:
City:_
Zip:
Pho
—w-16ni %,v i rtr+La un Hrrluvi l : Appiicatton 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, 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 the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing work or recording your Notice of Commencement.
Signature of wner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF 113 (, IAA e 1wil
Sworn to (or affirmed) and subscribed before me of
Phsical Pres nce or Online Notarization
th s day of 204�4 by
Name of person making statement.
Persona"tgn OR Produced Identification I< __
Type of Identification
Produced
(Signature of Notary Public- State of Florida )
C missio . .....�i,�(Seal) MtCHAELRAAZ
Commission # GG 31862(
Expires July 28, 2023(
of Contra ctorYi4censel-[older
STATE OF FLORIDA
COUNTY OF St Lucie
Sworn to (or affirmed) and subscribed before me of
PhysicaI Presence or Online Notarization
th {l�day of /"Y7 ,i�" 2Q_
Justin Thi .ry
Name of person making statement.
Personally Known X OR Produced Identification _
Type of Identification
Produced
(Signature of Notary P lic- State of Fl�o;idau),� MICHAEL RA
Commission # GG
Commission No.
," 0a'1) Expires July 28,
Ut FO'Q Bonded Thor Budget Nott
" Bon ed Thm Budget Notary �u. osREVIEWS FRONTJZ�'_�IG SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTERREVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED