HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �y
Crater ^ Permit Number:
y.. A Building Permit Application
Planning and Development Services
Building and Cade Regulation Division Commercial X' Residential
2300 V rginio.Avenue,Fort Pierce Ft 34982
Phone:(712),462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR: Island Kitchen & Bath
40
49
Address: � Q t o, :.. tv _� ..e1.-l: � £
Property Tax ID#: o— - . Lot No.
Site Plan Name: I_`_> - Block No.
Project Name:
New Electrical Meter Second Electrical Meter
>� -: , ka ¢a r`¢4� ""e S� p� -�s r*- _ ^: ,�»r•t �i y, .��� Aye �� q•
lT� v
_oa.•, a_.-..._..o.SY✓.�..,.fin . �C, �.ws�- ..F„-.>A- .... � a „p _
Additional work to be performed under this permit--check all that apply:
—Mechanical Gas Tank —,Gas Piping _Shutters _ Windows/Doors Pond.
_-lk-ctric (umbing _Sprinklers Generator Roof _Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cast of Construction:$ - Utilities: ,Sewer Septic Building Height:
_..S».,.._.. a . ./" .' .� a. _ e, r . .;w.__r •>. _ ...,:'. Y,3,Y��'n• ...... ,..... . Xa"L.'h..nx. .k..¢--,.
Name ram- Name:Justin Thiery
Address: Company:Island Kitchen,&Batyh
City: � &41( State: Address:90875 5 Ocean Drive
Zip Code: Fax: City: Jensen Beach State:Fl
Phone No f=r.ems- Zip Code: 34957 Fax:
E-Mail: f2CAALJJSri a ., G a d`01 " Phone No772-237-7348
Fill in fee simple ilia Molder on nex#page(of different E-Mail ikb.pm.assistant@gm`aii.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.
I
�.�,�' . .;s.., .,,»�,., ... r ,.: :.": .,.� �„ ���✓,,,. �..� ...
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: — Not Applicable;
Name:. Name;
Address; Address
City; State. City Stater
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 AFFIOVIT:Application is hereby rnade,tc obtain a permit to clothe work a.nd instaliationas 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 Nome 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 mayapply.
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 wilding 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 'iinspec on: If you intend to obtain financing, consult
with lender or an attorney before commencing work or recor` in our Notice of Commencement.
Si nature f OwnerJ Lessee/Contractor as Agent for Owner ignafure of Contractor Lice ;e Hold
STATE OF FLORI.DA ATE OF FLORIDA
COUNTY OF ``s —. c►: COUNTY OF SILtwiee
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization x Physical::Presence or Online Notarization
this 4 day of L.t.L s; 207.,0 by this day of 202 by:
� t
2 4:_ i Justin Thiery
Name of person"making statement. I Narne of person making statement.
Personally known OR Produced Identification '"" Personally Known x OR Produced identification
Tygeofldentificatior Type of Identification
Produ ed Produced
r'(Sign ure ry Public- for d (Sig ture of ti ary lic of Floridg1JtHAELRW
Q� E gtt$ �� •. ,� °* Commission#GG 31662Q
,.
t Commissio o. °�xr KGo� CommiS5ion,No.. oY E 41y la,1023
nCtio@� BandedThNBUdgetN64AtyS8tv1W8'
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE -
COMPLETED
ev