HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALLAPPLICABLE INFO MUST BE COfl_,-_.,iTED FOR APPLICATION TO BE ACCEPTER
Date: SCANNED Permit Number.
BY
St. Lucie County
RECENED
Building Permit Application SUN os 2018
Planning and Development Servics
Building and Code Regulation Div ion Permitting Department
St. Lude County
2300 Virginia Avenue, Fort Pierce L 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION
Address:—W'�
Legal Description:
: r�o U u'l _
Property Tax ID #: -65SS -
Site Plan Name:
Project Name: Croc_,irc
Setbacks Front
e1-1❑AC ❑ctric ff Ph
Total Sq. Ft of Construction:
Cost of Construction: $ y
t2 -. �
City: \ erSSC-(-, f?Scr�c I
Zip Code: 3`1SS')
Phone No. C Steil 9M -
Fill in fee simple Title Holder
from the Owner listed above
Renovation
Right Side:
Left Side:
Gas Piping "shutters
Sprinklers ❑ Generator
_ S Ft. of First Floor: _
Utilities:n Sewer ❑ Septic
Lot No.
Block No.
Windows/Doors
❑ Roof = Roof pitch
Building Height:
�c'ff Name: Justin Thiery
k�ir \CYia Company: Island Kitchen and Bath
State: _Vt- Address: 10875 S. Ocean Drive
City: Jensen Beach State: FL
Lo Zip Code: 34957 Fax:
Phone No. 772-678-8219 - 772-237-7348
next page (if different E-Mail: jthieryikb@gmail.com; nblaszkaikb@gmail.com
State or County License: CBC1259508
If value of construction is $2500 Or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER:
_ Not Applicable MORTGAGE COMPANY:
_ Not Applicable
Name:
Name: Justin Thiery
Address:
Address:
City:
State:
City: Jensen Beach
State:
Zip: Phone
Zip: Phone:
I
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY:
_Not Applicable
Name:
Name:
Address: 10875 S. ocean Ddve
I
Address:
City:
I
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFI )VIT: Application is hereby made to obtain a permit to do the work and Installation as indicated
I certify that no work or installatiogi has commenced prior to the issuance of a permit.
St. Lucie County makes no represei itation that is granting a permit will authorize the permit holder to build the subject structure
which Is in conflict with any appl ble 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 ti his requested permit, I do hereby agree that I will, in all respects, perform the work
In accordance with the approved p ans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit appli tions are exempt from undergoing a full concurreney review: room additions,
accessory structures, swimming pc 31s, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your ilure to Record a Notice of Commencement may result in your paying twice for
improvements to your prope ty. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If jou intend to obtain financing, consult with lender or an attorney before
commencink work or recordi i= vo "otce of Commencement.
''Signature of Owner/ Lessee/Contractor
as Agent for Owner
o 0 o actor/License Holder
STATE OF FLORIDA
=ATE F FLORIDA
COUNTY C sc u ce
COUNTY OF sL Lude
The forgoing instrument was ackl
owledged before me
The forgoing instrument was acknowledged before me
this S day of -)u^^—c
20-�% by
C:k�—
this S day of J LL^G 20 IS by
Justin Thiery
i)Cl-MCS 1'e. C..fZ.V,
Name of person making
statement
Name of person making statement
Personally Known OR P
oduced Identification x
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced ori— U—
Produced
(Signature of Nota to
a of Florida)
(Signature of Notary P ate of orida )
Com on N ^ SOe11
O e gal) MICHAELRAAZ
°&PAY ep� IOHAEL
Cammissio o. F� O�
IMISSIO RAAZ
,r * MY COMMISSION A FF9041
EXPIRES:Juty28,2019
R�i�g
4l4p
° EXPIRES: July28, 2019
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Rev.B/2/17