HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL�APPLICABLE INFO MUST BE COMPLE._� FOR APPLICATION TO RE ACCEPTED
Date:
Permit Number: l W1 - 01 ps
SCANNED
tW, BY
OVA
r�3.r St. LUci6 Cou {�/ RECEIVED
Building Permit 41 plication
Planning and Development Services Jul 11 2016
Building and Code Regulation Division
2300 Virginia Avenue,, Fort Pierce FL 34982 Permitting Department
St. L
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial ResidentiarCountyc
PERMIT APPLICATION FOR: Renovation III
Address: \0o4%1 S. Oce_o.n ter t&gF 08 x-,¢ � beach , qrL NgS7
Legal Description: Sc-a- w"no\S Cor%dom nkkly R-n\-L.OR (nR 4010-$l16
r
PropertyTaxlD#: c-\60a•i-O`4-004$-Cc)o-C!
Lot No.
Site Plan Name:
Block No.
Project Name: \cd\yO— Q,r-,cjenf.\,,D r -
Setbacks Front Back: Right Side:
Left Side:
A
�a 11 O."I'F R"AT
itiona wor to e e orme un ert ispermrt-c ec
a appy:
11HVAC Gas Tank ❑Gas Piping
Shutters
Windows/Doors
9 Electric ® Plumbing Sprinklers
rr_��
Il Generator
Roof
Roof pitch
Total Sq. Ft of Construction:
S�Ftj. of First Floor:
Cost of Construction: $ 22r CaYb Utilities: LJSewer OSeptic
Building Height:
SSE
N A OR, ?'
Name J6nrn W. Goc erg--rArNnA-i
Name: Justin Thiery
Address: \iDCY-1k S. OCeo.r-i 17f��% ln(�Sr
Company: Island Kitchen and Bath
City: Ae'-lSer\ deca_ch State: Ri.—
Zip Code: S`lgSi Fax:
Phone No. CIDi-t- LoR(nS
Address: 10875 S. Ocean Drive
City: Jensen Beach State: FL
Zip Code: 34957 Fax:
Phone No. 772-678-8219 - 772-237-7348
E-Mail: 3D\ 0 o.o( _ CDm
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
If value of construction Is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address: 10875 S. ocean Drive
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name: Jusun Thiery
Address:
City: Jensen Beach State:
Zip: Phone:
BONDING COMPANY:
Address:
Zip: Phone:
_Not Applicable
V1IVIYCn/ l.Vl4I KA{.I UK A"IUVI I: 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 ano 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 recordine your Notice of Commencement_
Signature bf Owner/ Lessee/Contractor as t for Owner
/License Holder
Si=EOZZIDA
STATE OF FLORIDA
S
COUNTY OF st woe
COUNTY OF st was
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this Lo day of 20,$ by
this _ day of _ . 20_ by
c J ,, co
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
Prod uced Drivers L mnw
Produced
(Signature I�,f. da j MICHAELRAM
(Signatur otary P c- State of Florida
..•.•• MY COMMISSION # FF W4140
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Commissio r SeaUXpIRES:dub 28.2019
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* My COMMISSION# FF904140
EXPIRES:JBI 28 2019
'for,° Banded Tbi
3 Budget Notery&,k,
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Rev. 8/2/17