HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
SCANNED
Date: BY Permit Number:
St. Lucie County
RECEIVED
Building Permit Application Jura 6S 2glg
Planning and Development Services
Building and Code Regulation Division Permitting D"rtment
2300 Virginia Avenue, Fort Pierce FL 34982 st. LtYcic' County
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMIT APPLICATION FOR Renovation
PROPn� E#} (�APROUEMENT
S;Y�-.k,.Wf ..,.x
Address: 8800 S OCEAN DR 205, Jensen Beach
Legal Description: ISLAND DUNES OCEANSIDE CONDOMINIUM II UNIT 205 (OR 3508-2837)
Property Tax ID #: 3535-603-0009-000-6
Site Plan Name:
Project Name: Cullen
Setbacks Front Back: Right Side: Left Side:
Lot No.
Block No.
dditiona work to e armedun ert ispermit—checka apply:
❑HVAC M Gas Tank ❑Gas Piping _ Shutters ❑ Windows/Doors
❑✓ Electric 0 Plumbing []Sprinklers ❑ Generator ❑ Roof ❑
Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ Oar 0-co Utilities: Sewer ❑Septic Building Height:_
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Name James P 8 Celesta Cullen
Name: Justin Thiery
Address: 8800 S OCEAN DR 205
Company: Island Kitchen and Bath
City: Jensen Beach _State: FL
Zip Code: 34957 Fax:
Phone No. 954-937-9758
Address: 10875 S. Ocean Drive
City: Jensen Beach State: FL
Zip Code: 34957 Fax:
Phone No.772-678-8219 - 772-237-7348
E-Mail: jcullen288@gmail.com
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 vame or construction is pczuu or more, a 11MUKUtU Notice at Commencement is required.
MORTGAGE COMPANY: _)( Not Applicable
Address: Address:
City: State: City: State:
Zip: Phone I Zip: Phone:
I
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: d087es.Oo Dde Address:
City: City:
Zip: Phone: I Zip: Phone:
OWNER/ CONTRACTOR AFFIIT: 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 his requested permit, 1 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 ilure to Record a Notice of Commencement may result in your paying twice for.
improvements to your prop e . A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If ou intend to obtain financing, consult with lender or an attorney before
cornmencing work or recordi g vour Notice of Commencement.
Signatuye of Owner/ Lessee/Con
rector as Agent for Owner
ign re Cont ctor/License Holder
STATE OF FLORIDA
STATE LORIDA
COUNTY OF st was
COUNTY OF sc Wtle
The for oing instru ent was ack
owledged before me
r
The for oing instrument was acknowledged before me
�
this 1,� day of ,�)a,,
. 20 /�by
this day offMy 20Jg by
Jany, �_ i
��
eJf�
Justin Thiery
Name of person making
statement
Name of person making statement
Personally Known OR Produced
Identification x
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced Dflwm ucense
Produced
(Signatur otary Public- St a
of id
(Sigpa a of Notary Pu I' -
Commission No.
Pe LFlAAZ
.F;ICHAE
Commission (Seal)
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EXPIflES: Juty 2B, 2019
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REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17