HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED Permit Number: I I
St. Lucie Countywills
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Building Permit Application NOV 2 9 2011
Planning and Development Services ,
Building and Code Regulation Division PERMITTING
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie County, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial _ Residential h
PERMIT APPLICATION FOR: Renovation
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Address:
Legal Description: \S\m,_, C°C sir -CdZ 01,41b1r Stogpr %n
11CbcvtM0 r. t'_\e- Ne-A+S
Property Tax ID q: 1IS11 - SI b - 067 Ct ' Cl6- (o Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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Additional worK to e perrormed under ispermit—check a apply:
11HVAC
Ga} Tank Gas Piping _ Shutters EI'Windows/Doors
_ Electric LJ Plumbing Sprinklers 0 Generator E]Roof Roof pitch
Total Sq. Ft of ConstructionS Ft. of First Floor:
Cost of Construction: $ 1 ps , 00c> Utilities: oSewer Septic Building Height: _
Name !:T21k' c+.Pl�herCii
Name: Justin C. Thiery
Address:�1D�(ZS Qft&P� Dew
Company: Island Kitchen and Bath of the Treasure Coast
City: Zen,er. 6epra,. State: eL
Address: 10875 S. Ocean Drive
City: Jensen Beach State: FL
Zip Code: 3y 01J�l Fax:
Phone No.
Zip Code: 34957 Fax:
E-Mail:
Phone No. 772-237-7348
Fill in fee simple Title Holder on next page (if different
E-Mail: jthieryikb@gmail.com
State or County License: CBC1259508
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER:
x Not Applicable
MORTGAGE COMPANY:
x Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City:
State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
x Not Applicable
BONDING COMPANY:
x Not Applicable
Name:
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: roomadditions,
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 recordine vour Notice of Commencement. _
as
STATE OF FLORIDA
COUNTY OF St ust:.e.
The forgoing instrument was acknowledged before me
this 7�rl- day of b�lr5___p��p� 20 t_by
OF FLOM
rY OF si. wcia
The forgoing instrument was acknowledged before me
this 2.i day of ►mowyn. ��� , 20 1]_ by
Q I�.Pen �U d Justin C. Thwy
(Name of person acknowledging) (Name of person acknowledging)
(Sigcrature of Notary Public -
Personally Known
Type of Identif Produi
Commission No.
Revised 07/15/2014
Produced Identification �L .
(MICHAELRAAZ
�_ MISSION it FF 904140
* FxPIRES:JuN28,2019
(Signature of Notary
No.
of
Identification
MICHAEL RAAZ
MY COMMISSION t FF9
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS