HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONINFO MUST
- 'FOR APPLICATION TO BE ACCEPTED
Date:
Planning and Development Sery
Building and Code Regulation D,
2300 Virginia Avenue, Fort Pien:
Phone' (772) 462-1553 Fax:
PERMIT APPLICATION
Address:
Legal Description:
Property Tax ID #: LAGo.1) - I.
Site,Plan Name:
Project Name:. Qc
Setbacks Front
.P94W,
11HVAC U Gas
gElectric Ful
L,cl Plul
Total Sq. Ft of Construction:
Cost of Construction: $ :2
Permit Number: 50
SCANNED
BY
�t. Lugie Co ty
Building rerinuil Applicati
34982
Z) 462-1578
Renovalion
Commercial 'N
Right Side:
Left Side:
AUG 2 4 a8
ST. Lu�;d COWIty P&mittir�a
Wa—clrfianti�*l kl-�'�'
Lot No.
Block No.
Piping Li Shut,ters L]Windows/Doors
nklers OGenerator ORoof Roof phch
I
S Ft of First Floor:
utilities'll Sewer E]Septic Building Height:
City: State:
Zip Code: 16) 0016, ��Q'6 F X:
Phone No. C Laxc;) C;%44 -%stc%
E-Mail:\S\ ro-Vsko�-S(ED- C1,CQ-! k, C-or�
Fill in fee simple Title Holder n next page (if different
from the 0
Name: jusun iniery
Company: Island Kitchen and Bath
Address: 10875 S. Ocean Drive
City: Jensen Beach State: Fl-
Zip Code: 34957 Fax:
Phone No. 772-678-8219 - 772-237-7348
E-Mail: ithieryikb@gmail.com; nblaszkaikb@gmaii.com
State or County License: CBC1259508
if value of construction Is $2500 Or more, a RECORDED Notice of Commencement Is
City:
Zip:.
FEE SIMPLE TITLE HOLDER:
Zip:
OWNER/ CONTRACTOR
I certify that no work or insti
St. Lucie Countv makes no re
structure.
In consideration of the granting of
In accordance with the approved 1
The following building permit appl
accessory structures, swimming pi
WARNING TO OWNER: Your
improvements to your prop(
before the first inspection. 11
commencing work or record
P401: AppiicaDie MORTGAGE COMPANY: Not Applicable
Name: JustinTwery
Address:
State: City: Jenwn Bwch State:
Zip: Phone:
Not Applicable 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.
te the permit holder to build the subject structure
or and covenants that may restrict or prohibit such
deed for any restrictions which may apply.
requested permit, I do hereby agree that I will, in all respects, perform the work
;, the Florida Building Codes and St. Lucie County Amendments.
ons are exempt from undergoing a full concurrency review: room additions,
fences, walls, signs, screen rooms and accessory uses to another non-residential use
ure to Record a Notice of Commencement may result in your paying twice for
. A Notice of Commencement must be recorded and posted on the jobsite
u intend to obtain financing, consult with lender or an attorney before
your Notice of Commencement.
A
'Signature of Owner/ k!!_�e/Conl
ractor as Agent for Owner
sit�=7ntor/Llcense Holder
STATE OF FLORIDA
STATE OF RIDA
RID
COUNTY OF so i-oe
COUNTY OF so Lude
The forgoing Instrument was ack
owledged before me
The forgoing instrument was acknowledged before me
this day
20_ by
this _ day of � 20 by
Justin TWery
_
Name of person makingistatement
Name of person making statement
Personally K'no,�n ___ OR Ptoduced
Identification X
Personally Known x OR Produced Identification
tific a
c; .tF
Type of Iden on
Type of Identification
Produced D ucense
Produced
(Signature of No ubli tal
of Florida
(Signatu ��:N—otary >Public-te of Florida
Comm� on "o FU,
ommissi ("91CHAEL RAAZ
MY COMMISSION # FF 904140
MMISSION # FF 904140
EX� .2019
EXPIRES: July28,2019
W
Bondad Rru Budg-t Notary Sentes
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17