HomeMy WebLinkAbout Bldg Permit Application - Heikoop ALL 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
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR:
Address:"(ce5p oC:.¢-a-w- lk,Yl.l� (OO`-t i �..I k1 JL �" P(� 5qq
Legal Description: 2[Lg l 004
Property Tax ID#: ei - I O- oc>c,- Oct— I Lot No.
Site Plan Name: i�_Y'_000 Block No.
Project Name: 1-14.oSd cjY�
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: — -
�t._.
'�L over c►-•� , s��-,...�..�.-r ...��c-¢� l�,.a��F �l asy 4----�{- I p(u-r`-°'c`� �-�.u'f-wr.��
Adclitional work to e e orme un ert is permit-c ec a apply:
11HVAC 11 Gas Tank Gas Piping _Shutters Q Windows/Doors
lectric umbing Sprinklers E]Generator Roof L—J Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 1� } � 00 Utilities: Sewer Septic Building Height:—
.° ., CONTRACTOR:
Na �C,
Name Name: Justin Thiery
Address: Qt� S 0cA-aw—t>r (00q Company: Island Kitchen and Bath
City: r State Address: 10875 S. Ocean Drive
Zip Code: S Fax: City: Jensen Beach State:FL
Phone No. CJC5- Z' `-7 V&+ 7 Zip Code: 34957 Fax: _
E-Mail: 1 Lb Pryl Cr.�IsLSt�f 09. Mo.d.j Loy?,N i Phone No. 772-678-8219 - 772-237 7348
Fill in fee simple Title Holder on next page(if different E-Mail: jthieryikb@gmail.com; nblaszkaikb@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.
®r
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:Justin Thiery
Address: Address:
City: State: City: Jensen Beach State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address:10875 S.ocean Drive 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 your paying twice for
improvements to your property.A Notice of Commencement must be recorded 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 our Notice of Commencement.
4
Si nature of Owner/Lessee/Contractor as Agent for Owner ure of Contract icens er
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF St Luce COUNTY OF St.L.de
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this -10i day of J 20,,-�f by this day of 20_4 by
NC L-4" N Justin Thiery
Name of person making statement Name of person making statement
Personally Known OR Produced Identification x Personally Known x OR Produced Identification
Type of Identification Type of Identification
Produced Drivers License Produced
Signat o ituUBM6Eklof Florida) ignature Not Public-State of Florida )
�' �O Commisslon#GG 318620 0,�, .r,� MICHAEL RAAZ
ComMi "�gplresJuly28,2023 (Seal) Commission GG31862�eal)
y'�t 2° BondedfiruBudgetNotery Servkee sr c� Explr.B July 28,2023
FOFF�oP Bonded Thru Boget Notary Swim
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17