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Home My WebLink AboutBUILDING PERMIT APPLICATIONf ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED C� /` Date: Permit Number: 1 03 — 03 11 SCANNED BY ST LUCIE COUNTY RECEIVED Building Permit Application MAR R y .M Planning and Development Services Building and Code Regulation Division Permitting Departm, t -2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie Cnun- Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X PERMIT APPLICATION FOR: Renovation Y (0 i AddresS905Doas w" 1�_LL4 Legal Description:(/,r�1,Y Property C) 1 C5—t)0 a Tax ID Lot No. Site Plan Name:n Block No. Project Name: Setbacks Front ack: Right Side: Left Side: , F�"I'g1`- ED >r�u I "'5N`.; p , : p. p S- 1�TRtits.. :0 itiona war to e e orme un ert ispermit —c ec all apply: 1]HVAC ❑Gas Windows/Doors Gas Tank Piping _ Shutters Q 11 Electric 0 Plumbing ❑Sprinklers Generator E]Roof Roof pitch Total Sq. Ft of Construction: S Ft. of First Floor: Cost of Construction: $ 2=rob' Utilities. Sewer Septic Building Height: Name Name: Justin Thiery Address:'/V � Oca II Q� 1L rr—// (- Company: Island Kitchen and Bath City;��___ _.State:.=-Address:_f0875S._OceanDrve_—_=______— Zip Code: (4Fax: City: Jensen Beach State:FL Phone N Zip Code: 34957 Fax: I,G E-Mail: J L Phone No. 772-237-7348 772-678-8219 Fill in fee simple Title Holder on next page (if different E-Mail: ithieryikb@gmail.com, nblaszkaikb@gmail.com from the Owner listed above) State or County License: CBC1259508 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPP 6 � , '��CCJ{VSl'RUC�TtO `� 1'�VV IN ORMA,4 -q:� r DESIGNER/ENGINEER: Name: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name•Jusunmie,y Address: Address: City: Zip: Phone State: City: Jensen Beach State: Zip: Phone: FEE SIMPLE TITLEHOLDER: Name: _ Not Applicable BONDING COMPANY: _Not Applicable Name Ad d ress:l0875 s. aeon Dave Address: City: City: Zip: Phone: Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. 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 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 Commencement. 4 1-ZQ,2,&4 Signature of er/ Lessee/Contractor as Ag6ht for Owner Sig ure of Contractor .icense Had r STATE OF FLO 1DA COUNTY OF ✓ r L t C"tom S TE OF FLORIQA COUNTY OF SI Wl L4 i The fo ing instrument was acknowledged before me The forgoing instrument was acknowledge l before me this day of r h 201 k—by this day of �C k 20 by AAI�C /1/rT(F-U 7H,>A'1Q-/ +yw .4MN Name of person making statement Name of perso k g statement Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature ofState of Florida) (Signature of Notary Pub' ate of I rida �ary-Public- Co rfNo. �1 r k (SWk'dMLflAAZ MUD Commission �.�o rr LRAA2 MP�SASIEON S FF M4140 My COMMISSION # FF , * ' EXPIRES: July28,2019 EXPIRES: July28,2019 e N6� Gams - — __ �^"tbFnoPA' [IonOeCThN Butlget Nohryservica__ REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE ' COUNTER REVIEW REVIEW REV EW REVIEW REVIEW REVIEW DATE '3 RECEIVED / Q DATE COMPLETED /G Rev.8/2/17 1/ /