HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL JWL1ABUEINFP MUST BE COMPLE1__ �'OR APPLICATION TO BE ACCEPTED
Date: SCANNED PermitNumber:
BY
St. Lucie County
Building Permit Application,
Planning and Development Servi fc�s 'L0uf1[,'._-errnittlng
Building and Code Regulation Divkion
2300 Virginia Avenue, Fort Pierce �L 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Renovation
Address:
Legal Description:
PropertyTaxlD#: Lot No.
Site Plan Name: Block No.
Project Name: 'tS N��! - cy�
Setbacks Front- 6ack: Right Side: Left Side:
+S
El - HVAC El Gas Tlink El . Gas Piping 1i S'hut'ters Windows/Doors
[A Electric 19plumialing OSprinklers ElGenerator Roof Roof pitch
Total Sq. Ft of Construction: S Ft of First Floor:
Cost of Construction: $ Utilities"Ll Sewer 0 Septic Building Height:
0 1 1
Namepw/rk' Name: Justin Thiery
Address:J�__o 5, 6_��414�6'z A 949? Company: Island Kitchen and Bath
city: �kxixem -ogeA I State: i-`1 Address: 10875 S. Ocean Drive
ZVCod e__: 3'195;7 F x: City: Jensen Beach State: FL
Phone No.klq _q1X_S6 _K Zip Code: 34957 Fax:
E-Mail: I Phone No. 772-678-8219 - 772-237-7348
Fill in fee simple Title Holder 4Jn next page (if different E-Mail: ithieryikb@gmaii.com; nblaszkaikb@gmaii.com
from the Owner listed above) State or CountV License: CBC;1 259508
If value of construction is $2500 4r more, a RECORDED Notice of Commencement is required.
City:
Zip:,
FEE SIMPLE TITLE HOLDER:
Oman Drim
ME
OWNER/ CONTRACTOR
I certify that no work or inst;
St. Lucie Countv makes no re
Not
State:
Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: jusun1wery
Address:
City: "nwnBwch State:
Zip: Phone:
BONDING COMPANY: —Not Applicable
Address:
City:
Zip: Phone:
VIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
has commenced prior to the issuance of a permit.
a permit will authorize the permit holder to build the subject structure
mation rules, bylaws or and covenants that may restrict or prohibit such
tion 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 p ans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit appll:ations 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, allure 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 �ou intend to obtain financing, consult with lender or an attorney before
commencine work or recordina vour Notice of Commencement-
__I�
tin Pre kof —se
I'
Ak�a,�jDL��
atu� Otnoer/ Les e;l�e
rVa cto r as Agent f o r Own e r
Slgnat� e of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF st L�e
COUNTYOFaL�
The forgoing instrument was ack
iowledged before me
The forgoing instrumept was acknowledged before me
this Jg� day of 1ILx,-,e
261S by
this kQ day of 3k..L�-e_ 26 L��by
Jusffn TWery
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 Dfi— U--
Produced
(Signature of
e of Florida)
(SignatuFe of Notary
Commission :twa =Pa-,)
(Seal)
MICHAEL RAAZ
�Public- �Sta �A�
Commission No. Seal)
My COMMISSION # FF 9D4140
W-4
*a MICHAEL RAAZ
* MYCOPAMISSIONIFF904140
1
WIRES: July 28,2019
1 '" cv�'� ..
�"0�40' Bondedl
YUNING
MudgetNotarySermes
�'eo"'We Bond ed
hmBud
REVIEWS
FRONT
SUPERVISOR
PLANS
VErETATioN
SEATURTLE
M 11
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17