HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
SCANNED
Date: \2�' • 1$ Permit Number:
BY
St. Lucie County
RECEIVED
i� Building Permit Application
APR 13 2018
Planning and Development Services
Building and Code Regulation Division 5T. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Renovation
Address: 9650 S Ocean Dr#1708 Jensen Beach, FL 34957
Legal Description: THE PRINCESS OF HUTCHINSON ISLAND UNIT 1708 (OR 1711-2762)
Property Tax ID #: 4502-610-0158-000-8 Lot No.
Site Plan Name: Block No.
Project Name: Hartzell
Setbacks Front Back: Right Side: Left Side:
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Guest Bathroom Remodel.
Demo, Plumbing, Drywall, Tile, Etc.
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Additional work to e performed un ert is permit— check a appy:
[—:IHVAC GasTank E]GasPiping _Shutters Windows/Doors
11 Electric ❑✓_ Plumbing Sprinklers Generator EIReof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 3,500 Utilities:Sewer 0Septic Building Height:
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Name Gary L Hartzell
Name: Justin Thiery
Address:9650 S OCEAN DR 1708
Company: Island Kitchen and Bath
-City: Jensen Beach State: FL
Address: 10875 S. Ocean Drive
City: Jensen Beach State: FL
Zip Code: 34957 Fax:
Phone No.772-233-1115
Zip Code: 34957 Fax:
E-Mail: glhartzell.gmail.com
Phone No. 772-678-8219 - 772-237-7348
Fill in fee simple Title Holder on next page ( if different
E-Mail: jthieryikb@gmail.com; nblaszkaikb@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: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name: Justin Thlery
Address:
Address:
City: State:
City: Jansen Beach State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Address: 10875 S. ocean Drive
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 Commencemen
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Signature of ner/ Lessee/Contractor as Agent for Owner
gnatur License Holder
STATE OF FLORIDA
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COUNTY OF St Lude
COUNTY OF st wde
abefore me
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The forgoing instrupeen�t was acknowledged before me
by
this � day of h�JG` \ 20_0 by
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JustinTNery
NaFie-oft4son diking-It4itliennent
Name of person making statement
Personally no n OR Produced Identification x
Personally Known x OR Produced Identification
Type of Ide if.cation
Type of Identification
Producced�Driv)ers Umnsa
Produced
(Signirtiure of Notary P c- t of Florida)
(Signature of Nota P orida-} --
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EXPIRES:July 28,2019
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.B/2/17