HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONt0A1-Rnrnhnm
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED Permit Number: Is () `I - L6 j
BY
St. Lucie County
Building Permit Application RECEIVED
Planning and Development Services APR 0 2 2018
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 Permitting Department
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residentialst. Lucie county
PERMIT APPLICATION FOR: Renovation , 1
Address: 8750 S. Ocean Unit 1734, Jensen Beach, FL 34957
Legal Description: Island Dunes Condominium A Unit 1734 AXIA Admiral Condominium
PropertyTax ID #: 3535-601-0088-000-7 Lot No.
Site Plan Name: Block No.
Project Name: Bumham
Setbacks Front Back: Right Side: Left Side:
Master and Guest bath room remodel. Demo, framing (curb), electrical, plumbing,
drywall, cabinets, tops, tile, etc.
MUU uIuua i WUIN w uo [JU[IIICU unueI um pennn—CnCCK au apply:
11 Gas Tank Gas Piping _ Shutters ❑ Windows/Doors
19 Electric ® Plumbing []Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ _20,000 Utilities:llSewer Septic Building Height:
ma T R
G iTR'AC OR`°M }�Fir
Y"Y
s.aa n -i. #e'
Name Carolyn & Charles Burnham
Name: Justin Thiery
Address: 2 Fresh River Vally Rd
Company: Island Kitchen and Bath
City: S. Dartmouth State: MA
Zip Code: 02748 Fax:
Phone No. 508-525-5911
Address: 10875 S. Ocean Drive
City: Jensen Beach State: FL
Zip Code: 34957 Fax:
Phone No. 772-237-7348 772-678-8219
E-Mail: carolyn. burnham(a)_comcast. net
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: ithieryikb@gmaii.com, nblaszkaikb@gmail.00m
State or County License: CBC1259508
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name: Juan Thiery
Address:
Address:
City: State:
Zip: Phone
City: Jenwn Beach State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address: down 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
commencingwowork or recording your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
S=ature ractor/ icnse Holder
STATE OF FLORIDA
COUNTY OF Si Lucie
SFL A
COUNTY OF st was
The forgoing instrument was acknowledged before me
this nday of (004C� 20jg by
The forgoing instrument was acknowledged before me
this day of MC?(hc K 20-a by
Justin Thiery
Name of person making statement
Name of person making statement
Personally Known OR Produced Identification x
Type of Identification
Personally Known x OR Produced Identification
Type of Identification
Produced Drivers Ucense
Produced
(Signature of No ublic- to of Florida)
(Signature of N FY P ic- Sta Florida )
Comm' on °'"4 ap MICHAELRW
* * MY COMMISSION 8 FF V1
m, °� EXPIRES:July28,2019
'+{> _z°a Bonded ButlgetNolary Serve
Co tssion °` :�� (SeNCHAELRAAZ
* k MY COMMISSION t FF 904140
"1 a°� EXPIRES:Juty28,2019
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEATURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17