No preview available
HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: of s 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 Address: Property Tax ID#:!!!4Sva- 001 OIL{ e 3 Lot N o. Site Plan Name: Project Name: Block No. ( �a � hp�l� y , �� J� _ L New Electrical Meter Second Electrical Meter Additional work to be performed under this permit -check all that apply: _Mechanical Electric el- — Gas Tank lumbing — Gas Piping _ Sprinklers Total Sq. Ft of Construction: Cost of Construction: $ Z 4 !S7. C)ID Name _ Shutters Generator Sq. Ft. of First Floor: Windows/Doors Pond Roof Pitch Utilities: _ Sewer _ Septic Building Height: Address:a-55b"S City: a—tN5 cA- _ State: Zip Code:. gg5,7 Fax: Phone No.. J'o E-Mail: �1 � <'ckou'v-.. 0 ',- 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 City: Jensen Beach Zip Code: 34957 Fax: _ Phone No 772-237-7348 E-Mail ikb.pm.assistant@gmail.com State or County License CBC1259508 -.--- -- -- -•---•-•• •- ---� �. c, a nF.-UrNUrU NOTICe OT commencement is required. If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. State: FI vw�V1\CR/CIYl711VCCK: Not Applicable MORTGAGE COMPANY: Name: — Not Applicable Address: Name: Address: CIS' State: City: Zip: Phone Zip: Phone: State: FEE SIMPLE TITLEHOLDER: _ Not Applicable BONDING COMPANY: Name: _Not Applicable Address: Name: City: Address: Zip: Phone: City: Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that nttoyywork or installation has commenced prior to the issuance of a permit. wth ch is in� onflic with any applicable�Home Owners tAsgociation� rules abylaws or andpcovena�ts that may restrictborproh bit 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 th lender or an attorney ttorne before commencin work or recording our Notice of Commencement. Signature of Owner/ Lessee/Contractor as Agent for Owner Si at a �C-ntr`act-rluc�eneolder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF S-r- (.. , I COUNTY OF St Lucie Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of :-15'hysical Presence or Online Notarization x Physical Presence or Online Notarization this APQ day of 2021 by this o �, _ ,/ .� day of � 2020 by r Justin Thiery Name of persbn.inaking statement. Name of person making statement. Personally Known OR Produced Identification Personally Known z OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of ry lic State of Florida) (Signat of Nota ic- State of Florida ) tiPnv'U©r� MICHAELRAAZ u Com o. °� M!r RAAZ ' * (6004isslon # GG 318620 Commission No. S ° o� Expires July 28, 2023 *( earli) ' GG 3f1@8?^ 9l Vices \fie r ''y 28, 202" REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE DATE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW RECEIVED DATE COMPLETE D re—v.