HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
97. LLLEE
®�� 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
IMESM
Address: _Gi Judd S dC e_"_'
Property Tax ID #: Ob4 U — 00O —
Lot No.
Site Plan Name: �L u-t'_ f'
Block No.
Project Name: Pbsl
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New Electrical Meter Second Electrical Meter
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Additional work to be performed under thispermit I
er m t check all that apply:
PP Y
_Mechanical _ Gas Tank ^ Gas Piping _ Shutters _ Windows/Doors
_ Pond
L-Itiectric —"'Plumbing _ Sprinklers _ Generator _ Roof
Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: —Sewer _ Septic Building Height:
Name O
Name: Justin Thiery
Address:
Company: Island Kitchen & Batyh
City: State:/,,nn —'L
Address: 10875 S Ocean Drive
City: Jensen Beach
State: FI
Zip Code:S�_ Fax:
Phone No. �J�Co - E—L45�z_4 —" L( i;elg_�.
I Zip Code: 34957 Fax:
E-Mail:
Phone No 772-237-7348
Fill in fee simple Tit Holder on next page ( if different
E-Mail ikb.pm.assistant@gmail.com
State or County License CBC1259508
from the Owner listed above)
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:
City:
Zip: Phone:
Not Applicable
MORTGAGE COMPANY: , Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:_
Address:
City:_
Zip:
Phone:
UWNtK/ LUN I KACTUK 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 commenrina wnrk nr rPrnrriinv vnnr 1kinrirga of rnmmcnrnm.n+
Signature of Owner/ Lessee/contractor as Agent for Owner
Sig u e of Contractor/Lt older
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF -n>T'. L,tl a 1 _�
COUNTY OF StLudee
SwXo 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 1lo day of p �, 202� by
this A� day ofa� , 202p by
0.
Justin Thiery
Name of person making st ent.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced _
(Sign ure of Not +@f Florid
* Commisslon # GG 318620
(Signature of Notar - Florid aMICHAEL RAAZ
,,
Commi n '"� ,or IfS16CM July 28, 2023
Commisslon # GG 318620
Commission o. �(S
�p��uly 28, 2023
OF r�° Bonded Th u Budget Notary Services
o�
�rFor P\ Bonded Thru Budget Notary Services
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