HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED D/�2
Date: SCANNED Permit Number: UX J
BY
} y, emu. St. Lucie County
Building Permit Application RECEIVED
Planning and Development Services AUG 0 7 %SIB
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 Permitting Department
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x St. Lucie County
PERMIT APPLICATION FOR: Window/door
I PROPOSED IMPROVEMENT:IACA`FION:r- III
Address: -Zc t \00P �) ASP �6 t V�L_ 3tic15_)
Legal Description: \S\c r,Nc.\ etc cs 0C_e_CLnS\C' .e_ kj-r" k a
t` oR t-I l t4 - t-S WN - tA\36 -• 434i
Property Tax ID#: 3535 •tpoo1.00T5cl •0Cx0• -Q Lot No.
Site Plan Name: C,r-UfGkiEA't Block No.
Project Name: rS\o.nCl tx.r..ne C—> CCeoa tCQSt
Setbacks Front Back: Right Side: Left Side:
11HVAC Gas Tank
DElectric OPlumbing
Total Sq. Ft of Construction:
Cost of Construction: $ a\, ccx 7
Piping II Shutters
Generator
Sq.l []Sewer
of First Floor: _
Utilities:Sewer Septic
Windows/Doors
Roof = Roof pitch
Building Height:
01NNEI2)1E55EE
CONTRACTOR:
Name 3r Mc,S Cxnr_%c-*
Name: JustinThiery
Address\: ����sS-0 S • Cy_f_cr\ —Ory 100'a
Company: Island Kitchen and Bath
City: l t�c� QiecLcF� State: EL-
Zip Code: Fax:
Phone No.
Address: 10875 S. Ocean Drive
City: Jensen Beach State: FL
Zip Code: 34957 Fax:
Phone No. 772-678-8219 - 772-237-7348
E-Mail:
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 52500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER:
_ Not Applicable MORTGAGE COMPANY:
_ Not Applicable
Name:
Name: Justin Trdery
Address:
I
Address:
City:
I
State:
City: Jwe=Eaeech
State:
Zip: Phone
I
Zip: Phone:
I
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY:
_Not Applicable
Name:
Name:
Address: 10875 s. omen olive
Address:
City:
City:
Zip: Phone:
I
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 represeqqqlotion that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any appli 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 his requested permit, I do hereby agree that I will, in all respects; perform the work
In accordance with the approved pans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit appli tions are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming po 31s, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your, pure 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. nd to obtain financing, consult with lender or an attorney before
commencir%work or recordi igvour Notice of Commencement.
"Sighafure of Owner/ Lessee/Contractor
as Agent for Owner
Si re ;ff ctor/License Holder
/
'STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF st twie
COUNTY OF sc Wde
The forgoing instrument was ack
owledged before me
r
The forgoing instrument was acknowledged before me
this N day of ,�,g$}
. 2018 by
this __L day of At.�. 20 VS by
Justin Thiery
Name of person makinOtatement
Name of person making statement
Personally Known OR P
oduced Identification x
Personally Known or OR Produced Identification
Type of Identification
Type of Identification
Produced o^iartra; IJcense
Produced
(Signatide of of Pint is-S�t�e
of Florida)
(Sign ur N(Kary4lrbbliV State of Florida)
Commission No.
(Seal)
ee"0 P" M11�/� E��R�AAAAll
Commission No. MYCOA1hIi35'I�W3FF904140
a°;•••.•
MICHAEL RAAZ
MY COMMISSION IFF904140+,F,F�eo-
EXPIRES: July 28,2019
BondedTnruBudgelNoerysenrces
+ueerti
Bonded Thru Budgeti
thry5eraw
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17