HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONrcr r - r • '
ALL APPLICABLE INFO MUST BE COMPLEfEO FOR'APPUcATION TO BE ACCEPTED
Date` ?. `� '� SCANNED Permit Niimbeii
ucie.Conn
`FEB O�g';2018
Buildin PermrtA Iications
r pp ST Lucie County, Permitting- -$ '"
• � Plann)ng and Development Serylces ,_ . X °
�Buildingand CodeRegulotlon Dluislon , ` r
23GOV�[gJ�iaAvenue, foRPle{ceF13A982>' � r ' � • `` - ,
Phone:(772)d62.1553 Fax:"(772)462=1578 r r Commercial x ::. Residential Y
PERMIT.APPLICATION FOR Renovation `�~ -
Legapt �Descri tion i?r Act 'C N I A t �' , r 3 2(0'L
I- . ` S. 2:
Property Tax ID #?.No.
Site Plah Name x BIocRNo.
0 ProjectName a
Setbacks front Back r Right'S�de Left Side
M �n r .NW�',��VL�'+•,
r
r
ono wo 0 orme un en s perm - c ec a apply:,
t� iHV �C Tank �fas Piping Shutters �:❑ Windows/Doors:
d
Electncmbing - ;.Sprinklers ", '� Generator.. . ' Roof` Roof pitch
c ; Total Sq.Ft oftonstrudion - Ft of F�rstrFloor : -
`Cost of Construction:Utilities Sewer'�Septic '. Budding Height: `
Name �., iName: Justiric Thlery
Addre s" Company Island Kitchen and Bath of the Treasure Coast --
State. Address -10875 �: Ocean City' . .
Lp CotleC Fax, �� Jansen BeaGi '- !" State. FL .
Phone"No. Z' - �: Zip Code:34957 Fax:
E Mafl; — Phone NWf
o 772 237-7348
Fill In-fedbhole Title Holderon extpage ( if di ` rent `E-Mali: )thieryip@gmeu.com-
from the Owner,listed above)' State or County License:
CBC1289508
If value of construction is $2500 dr more.'a RECORDED No416e of Commencemenf is requked: a
`DESIGNE ENGINEER: `- "x ,Not-App icabie " `.'
Name:
MORTGAGE{OMPANYt x Not Applicable
Name:
Address: -
city." State:
Zip: Phone:
Address:
City:. State:
Zip: Phone:
FEE, SIMPLE TITLE HOLDER: x Not Applicable
Name:
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.
In consideration of the granting of this requested permit,a do hereby agree that will, in all respects, perform the work
n*to`rdance 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, screep'rdoms and accessory uses to another non-residential use
WARNING TO OWNER: your"failure to Record a Notice of Commencement may result jo your payingiwlce 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
/ignature w uwner/Lessee/Lontraetor as agent for Owner SI natur f C3 t ctbr/License'Holder
STATE OF FLORIDA y� r 1 CO TE OF FLORIDA '
COUNTY'OF _` S1 i Um _ COUNTY-OFsL"
The ��qq((ggoing)nst n as ac owiedge efore me The forgoing Instrument was acknowledg efore me
this'�`'t, day of 20 .,bq this , day ok 20 by
JusItn C. Thlury
Name of ,(person acknowledging)
i p g) (Name of perso knowledging
(SigAture46f Nqf6ry P bllc- St to of Florida) (Sign ure of fa" ublic- Sta e-of'Florida )
Personally Known OR Produced Identification . ✓ Personally Known X OR Produceds,tl Imification "
Type of Identification,Produced ( - Type of Identification Produced 110.. ••`O� IdICHAEL
Commission No.)2" .5Lro, MICHAELRAAZ w x' MMIdYCO SSION9ppgpq
01alkfyCOMMISSION tFF904SommissionNo. �! G s, it EXPIRE ,1428,201.
a * Ides , ondedRru Budget NotaryS,
EXPIRES: July28,201
Revised 07/1S/2014
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