HomeMy WebLinkAboutBldg Permit App_000142All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
0 u ' co' _ ' 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) 462-1S78
PERMIT APPLICATION FOR: Island Kitchen & Bath
PROPOSED IMPROVEMENT LOC N:
Address: c1 I4
Property Tax ID #: AD1 s - 01- C> Uaq - C-�'C>G _ QL Lot No.
Site Plan Name: Block No.
Project Name:V\-^
DETAILED DESCRIPTION OF WORK:
Cm n�Ju%ibj2 p (� Albl `� X Wf�� Gi kk l l./�r:�-W Ci 01 1
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
X Electric (Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ b of Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE a s Ft
Name
CONTRACTOR:
Name: Justin Thiery
Company: Island Kitchen & Batyh
Addr1e\ss: �i i �r, l�
cityState:
Address: 10875 S Ocean Drive
City: Jensen Beach State: FI
Zip Code:, �L�iAc� Fax:
Phone No. C��-5- nC) 1 -�S U
Zip Code: 34957 Fax:
E-Mail: V1G
Phone No 772-237-7348
_
Fill in fee simple Title Holder on next page ( if different
E-Mail ikb.pm.assistant@gmail.com
from the Owner listed above)
State or County License CBC1259508
If value of construction is 2500 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.
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
Citv:
Zip: Phone:_
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:.
Not Applicable I BONDING COMPANY:
Name:_
Address:
City:_
Zip:
Phone:
_ Not Applicable
tate:
Not Applicable
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 attornev before commencing work or recording; vour Notice,of Commencement.
Signa a of Ow r/ Les a/Contractor s Agent for Owner
Sign ture of Contr tor/Lic se Holder
STATE OF FLO A
STATE OF FLORIDA
COUNTY OF�i � k A_.PA`-e-
COUNTY OF St Ludee
Swrto (or affirmed) and subscribed before me of
Sworn to or affirmed) and subscribed before me of
Physical Presence or Online Notarization
x Ph sical Presence or Online Notarization
this Aday of /�-nv� � 202$ by
this day of 14Vril 2024 by
LI / \
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
(Signature of Notar tate of Florida)
MICHAELRAAZ
(Signature of Notary c- S of Florida )
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Com o ap : "''• saUA
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��R' MICHAEL RAAZ
Commission No. .• •••. deal # GG 31
+ Expires July 28.2023
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Rev. 5/6/20