HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
SCANNED Permit Number: l-11 0.0i 9 9 Date: BY
St. Lucie County
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential It
PERMIT APPLICATION FOR: Renovation
Address: _9 z5r) t) ,z, nc-e-4s,21 -a-)r -it Tog ;:\-er)14S4n, A
Property Tax ID #: q5 O a - "a - bibikk - (M-S Lot No.
Site Plan Name:
Project Name: �T�T.Pn� i2moatL�
Setbacks Front Back: Right Side: Left Side:
Block No.
t'e,,> - `erl1L' _e IrXvll '� n P n kY� I r0.Ts� C e-i L7^a- i n
QemA>� in54wt_t_ +_r`1J Li6,h-F,S in
QWindows/Doors
11 Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 40 10t� UtilitiesSewer 1:1Septic Building Height:
�t
r #fif LESS0.0
'
Name Sr-, CA 3
Name: Justin C. Thiery
Address: ci5W .5• OC?sin 'Dr S7)U`f
Company: Island Kitchen and Bath of the Treasure Coast
City: 3enP ,fn QIG.Gh Stater
Zip Code: �J 'I Fax:
Phone No. SSHS_ bta'7- jS?ofi
Address: 10875 S. Ocean Drive
City: Jensen Beach State: FL
Zip Code:34957 Fax:
Phone No. 772-237-7348
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: jthieryikb@gmail.com
State or County License: CBC1259508
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
UP 1 E TL G r -
DESIGNER/ENGINEER:
Name:
N l l LA FOR
x Not Applicable
lO
MORTGAGE COMPANY: X Not Applicable
Name:
Address:
Address:
City:
Zip: Phone:
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
x Not Applicable
BONDING COMPANY: x Not Applicable
Name
Address:
Address:
City:
City:
Zip: Phone:
Zip: 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 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 your paying twice for
improv ents to your property. A Notice of Commencement must be recorded and posted on the jobsite
before tie first inspection. If you intend to obtain financing, consult with lender or an attorney before
com a c PM work or Pbcbrdine vour Notice of Commencement.
STATE OF FLORIDA
COUNTY OF S� L-I, w .•
The forgoing instrument was acknowledged before me
this 2�L day of/rirJ hr/ . 20 J_-�by-
ItI)R' tjr �'- 6Ggh S
(Name of person acknowledging)
OR Produced Identification
Type of
Commission No.
Revised 07/15/2014
'FLORIDA
OF u u, a
The forgoing instrument was acknowledged before me
this ZCi day ofYul , 20 by
Justin C. Thiery
(Name of person acknowledging)
(Signature of of Florida )
nally Known OR Produced Identification
of Identification Produced
nission No. �,� JSeal) MICHAELi1/WZ
MY COMMISSION I FF 9D414D
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS