HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR AP '40,,r�11 �{ICATION To BE ACCEPTED
Date: /1/' �• ro ,r►kED "Permit Number: lQ �^ O
It BY
_' • ,�5f Lucie Countv
6uildingPermitApplication RECEI�OED
Planning and Development Services Building and Code Regulation Division OCT
18 2016
2300 Virginia Avenue, Fart Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
Residential
PERMIT APPLICATION FOR:
Renovation
P.ROPOSFIhIhADDlvc�nr r. Gr .... 11
Address: 1 O5S
Legal Description:
Property Tax ID #: ���
Site Plan Name
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Lot No.
Block No.
+x. . t'•.o .. 4vn �' ivn vl'YVVRt\�f �. a.., .„n � rt �" # I,, , 2,.".� c .5-"s t 1i S�
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CGrpef 1 t'a�Q r C..�jL: tin e..�,a,`ta-1�l,c.-$�t_glleC;C.r C:w\a-J �Jlwwtrn ��
mr�wry fnv pl/1tIVIPoU(1Nt'
o a war o e a �euer+spermd—cec at�1HVa W ��/G❑Gas Piping _Shutters Windows/Doors
`_\ Electric L-nPlumbingSprinklers UGenerator
Roof
Total Sq. Ft of Construction:
S F[. of First Floor:
Cost of Construction:$ la00i000 Utilities:Sewer❑Septic Building Height:_
OWNER/L"E55EE+ r` h` C t a CONTRACTOR
NameLr l /
... . r Name Justin Thiery
Zip Code:
Phone No.��7 —
State: FL
Fill in fee simple Title Holder on neittlpage ( if different
from the Owner listed above)
If value of construction is $2S00 or more, a RECORDED Notice of
Company: Island Kitchen 8, Bath
Address:C� or
City: UQYI$� �Q yL,� y t State: FL
Zip Code: L►clti� Fax:
Phone No. (772) 678-8219
E-Mail: ithierykb@gmail.com
State or County License: CBC1259508
required.
4
Name:
��� r,NPncaoie
Address:
City. State:
Zip: Phone: ---
FEE SIMPLE TITLE HOLDER:
Name: — Not Applicable
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Name: Not Applicable
Address:
City: State:
ZIP: Phone:
BONDING COMPANY: _Not Applicable
Name: suro Toclnsuroncocpnpony
Address: 10]a Pou 0u4 BIvJ
City: „owtan
Zip: 77M Phone:
I certify that no work or Installation has commenced prior to the issuance of a permit.
which is In conflict with any applicable lHome Owners Assoclatlondrules,authorize
bylaws or and covenants that mayl. 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
commencing work or recording our Notice of Commencemen
STATE OF FLORIDA
COUNTY OFa u� L
The forgoing instr nen wa acknowledged before me
this JZday of� 20 I4by
C'�G� 'r
(Name of ersol acknowledgin
of
...,... u,r mown OR Produced Identification
Type of Identification Produced
Commission No _� (Seal)
Revised 07/15/2019 n�* XPIA al7NgFF9pFK
EXPIflES:429, 2019
cornrow Brrdedalro ButetNobrysmkn
.REVIEWS FRONT ZONING
COUNTER I REVIEW
INITIALS
CIA
OF
The forgoing instrument was ac owledged before me
this M day o0L�CA_4 lM/Zp1&y
Juan Thicry
(Name of person acknowledging )
'..� o��
(Signature of N�PubllS o Florida )Personally Kn NR Produced Identification
Type of Id . ation Produced
Commission
SUPERVISOR I PLANS VEGETATION I SEA REV RT E I MANGROVE
REVIEW REVIEW REVIEW
T