HomeMy WebLinkAboutJames Shearer Permit Application_000316All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
9Vo LUr, C01E
.. o
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
Address:
Property Tax ID #: q50'c) CC-0 - O Lot No.
Site Plan Name: Block No.
Project Name:
? U
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit —check all that apply:
Mechanical _ Gas Tank _ Gas Piping
jQ Electric Olumbing
Total Sq. Ft of Construction:
_ Sprinklers
Cost of Construction: $
Na
_ Shutters _ Windows/Doors _ Pond
Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer _ Septic Building Height:
Address
CitytK State:V --
Zip Code:Fax:
Phone No.21:D _ 00a C.;'
E-Mail: k,--x\r'-
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: Justin Thiery
Company: Island Kitchen & Batyh
Address: 10875 S Ocean Drive
Citv: Jensen Beach
Zip Code: 34957 Fax:
Phone No 772-237-7348
E-Mail ikb.pm.assistant@gmail.com
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.
State: FI
DESIGNER/ENGINEER:
Name:_
Address:
Not Applicable I MORTGAGE COMPANY:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
Name:_
Address:
City:
Zip:
Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
_ Not Applicable
State:
_Not Applicable
UWNLK/ LONTKALTOK 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 olommencinE work or rprordinor vnur NotirP of rnrnnnPnrPmPnt
Si nature of Owner/ Lessee/Contractor as Ag nt for Owner
Si a of Contra c se Holder
TATE OF FLORID
STATE OF FLORIDA
COUNTY OF �� P�'�
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 Presence or Online Notarization
this _ZL_ day of� ems, 2020 by
this day of 2020 by
S� ��i��
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
Sign tur Nota P S �Pg Florida
- tip 6CHAEL RAAZ
Si at of a Public- S lorida
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m slon # GO 318620
Commission No. *� * C(ea�
201�,...c MICHAELRAAZ
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Commission No ��
o� xp es July 28, 2023
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FOF (00 Bondod Thru Budget Notary Services
; o� Expires July 28, 2023
For FLOP XarysmVION
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/5/20