HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLIL�,{/�BLLE INFO
/MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: / ` �` i SCANNED Permit Number:
BY
E�M.- St. Lucie County
R"CEIVED
Building Permit Application APR 182010
Planning and Development Services Permitting De
Building and Code Regulation Division St. Lucie co�ntyent
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial_ Residential
PERMIT APPLICATION FOR: Renovation
Legal Description:
im
Property Tax ID f1i: ` �3 — oo I — CiI3 I r�GG - Lot No.
Site Plan Name: \A\1A5Ph�n. S Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
Dtnw� 1�ir<.nnv7 �fecJrrzc r,'�! „q cl�r�t�csl� .4-4 ec./oZ06r , 03,
Uua, waun w uo anu„ueu uuue, unb Pen nn—cneI-rc do dpPry:
HVAC Gas Tank Gas Piping _ Shutters ❑Windows/Doors
Electric Plumbing Sprinklers Generator 1:1Roof = Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ jS5i orcyo
S Ft. of First floor: _
Utilities: Sewer E Septic
Building Height:
MR
NameYYltr,A c " �A ACoar lA
Name: Justin Thiery
Addre``ssCl�� 5 OCo c-n nr ILAU"Ji-
Company: Island Kitchen and Bath
City. \D�aj()�,0 q�it�l State �
Zip Code: c�v\aS-1- Fax:
Phone No271S -SaG—
Address: 10875 S. Ocean Drive
City: Jensen Beach State:FL
Zip Code: 34957 Fax:
Phone No. 772-237-7348 772-678-8219
E-Mail: Y) VIL
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: jthieryikb@gmail.com, nblaszkaikb@gmail.com
State or County License: CBC1259508
It value of construction is RSIID or more, a RECORDED Notice of Commencement is required.
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 priorto 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
commencingwork or recordingour Notice of Commencement.
Rev.8/2/17
SIJpP `E:� r� NSTR�CfI • �
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DESIGNER/ENGINEER:
Name:
Not Applicable
MORTGAGE COMPANY:
Name:�estl�TNe�
Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City: �anse��ern
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER:
Name:
_Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address: +ems s_ �� on�a
Address:
City:
City:
Zip: Phone:
Zip: Phone:
Sjf}nature of caner/ Lessee/Contractor as Agent for Owner
!gnat e o ontr ctor/License Holder
STATE OF FLORIR� 1
Ufi
TATE OF O DA
�� i�lti(��,C
COUNTY OF l�liLCi1`Z
COUNTY OF
The fo oing instr ment was acknowledged before me
The fo oing instrument was acknowledged before me
�dayof�e�hJ
this�dayof��20�by
this ,20�� by
Name of person making statement
Name of pers making statement
Personally Known OR Produced Identification
Personally Known � OR Produced Identification
Type of Ident ca on
�
Type of Identification
Produced
Produced
(Signature o ary P ic- State of Florida)
(Signature o ry Public- Stat f Florida )
Co is ' o. ` �Lal)
Co �n� (Seal)
� MICHAEL Rglp
*�My COMMISSION t FF 904140
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* � MYCOMMISSION tFF904140
* E5: Ju 26, 2019
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