HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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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
Pk ROPOSED IMPROVEMENT LOCATION: `-
Address:_ � C> y. �JC�—�� �� .1Q S� L¢..e`,v-�
Property Tax ID#: j - o ( y�ct .� j . G Lot No.
Site Plan Name: ICir1l� Ps - I�O�d en Block No.
Project Name:
4DETAILE�DDESCRIWTDON OF WORK:
C aZ t Il,V w,Q
�..c��.-e�a�G�,ny s�_� �c., �l 5� c ►�.�
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
Vilectric Plumbing _Sprinklers _Generator —Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction. $ �, 4�. 00 Utilities: _-Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name, n�-"r-N �An\ 6:QZ-) Name:Justin Thiery
Address: ':Zil CDC o r,-.,� Q._ L-AUrj Company: Island Kitchen & Batyh
City: IS o,c) ay L � Stater Address: 10875 S Ocean Drive
Zip Code: Fax: City: Jensen Beach State:FI
Phone No. :;�C_211l ��� . ���� _ _ Zip Code: 34957 Fax:
E-Mail:d►hot6f_ e;r��aP,�w I Phone No 772-237-7348
is Fill in 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.
"W"ONEW.-
DESIGNER/ENGINEER: _Not Applicable 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 lehd r or an attorney before commencing work or recQrding your Notice of Commencement.
Signature o O n&j Less J ontractor as Agent for Owner ignat re of Contractor a Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Wit 1A Lr ,3C _ COUNTY OF StLuciee
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 Pre ence or Online Notarization
this'J�day of 2020 by this 84-k day of 2021 by
ao ew� 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 Notary P orida) (Signature of tar lic-State of Florida)
s MICHAEL RW
Com o. �pyru.4c Comm GG318620 Commission No. .rn!. � MICAµ
+ ,� Expires JI 28,2023 Commission#G 318620
' dadThuBudgetNolarySevfrns
lr s July 28,2023
0FW Forr• P\ Bonded Thru Budget t MANSewires
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Re—v—. 576/20