HomeMy WebLinkAboutBUILDING PERMIT APPLICATION- W ( (cybyr
ALL APPLICABLE INFO MUST BE COMPLETEb FOR APPLICATION TO BE ACCEPTED
BY
SCANNED
Date: BY Permit Number:
St. Lucie County (fle
Building Permit Application qlu rn din r,
Planning and Development Services
Building and Lode Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Building �eXl p�/G Cj� III
ORnp'O-kP IIViPRnVFMFNT.I nc..ATI(lN;t-
Address: 100 c-f-4 5 CXgn0 /% Ta
Legal Description: �a i� n_ _ � J (Od.S Lr-)610 t in i ,3wL pe* 8�U3 LO(Z 3a
Property Tax ID #: 4562— 6ez'-1 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
1 DETAILED"DESCRIPTIO,N OF. WORK ` --
See A6,r-W c6-- tic�
CONSTRUCT
YION;INFORIVlATION.;;
u .. .., c.
Additional work to be Dertormed
under
tispermit-check
all
apply:
OHVAC
Gas Tank
❑Gas
Piping
_Shutters
❑
Windows/Doors
"Electric
Plumbing
Sprinklers
Generator
Roof
Total Sq. Ft of Construction:
S Ft. of First Floor:
Cost of Construction: $ i 2 i gd0
Utilities :'nSewer E] Septic
Building Height:
,OWNER/LESSEEt''.
, 4
CONTRACTOR } _'..,-•
Name nAi6yel H Uy6gh0- ((r-&
i VVd?I11
Name: Justin Thiery
Address: 10,g50 NlN 16'v% f L
Company: Island Kitchen & Bath
City: f emlpn)Y2 Pir+'Es
Zip Code: 3 302_(o Fax: !
Phone No. '95C1 - �-LS- S��b
State: FL
Address: 2340 SE Charleston Dr.
City: Port St Lucie State: FL
Zip Code: 34952 Fax:
Phone No. (772) 678-8219
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: ithieryikb@gmail.com
State or County License: CBC1259508
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
� 101 F41- - hl ri'a h Y
SUPPLEMENTAL CONSTRUCTION LIEN: LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name: Sum Teo lnsumnw company
Address:
Address: 1330 Post oak aivd
City:
City: Houston
Zip: Phone:
Zip:77o5S Phone:
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 thedpermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or an 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
commencine work or recording vour Notice of Commencement.
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF i54-. U)cle I COUNTY OF
The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day ofNtILIEM bw 20 14 by this i 1 day of Prn / . 20__JA by
YYlir_wel +1. Wrf4h+
(Name of person acknowledging (Name of person acknow{lin )
leedg
'
(Signatur of Notary Public- State of Florida) (Signatu of Notary Public- gate of Florida )
Personally Known OR Produced Identification v/ Personally Known OR Produced Identification
Type of Identification Produced j riVCScs ) feeV1%,AL__ Type of identification Produced ^. _ ^'^ ^
v "'04M DAYNA J. REGIS MISSION 0 FF 109457
Commission No.r%/o9y5* +' al)MYOOMMISSIONOFF10 ommissionNo. i-F 10145�; (*OW
• Inca; Api l2, 2018
„ EXPIRES: April 2, 201 `'+.,_-_�Pf aan4edThiu BuA9etNolatysenicee
Revised 07/15/2014
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