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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONG U t-�deL�� C_ ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED '��� Date: SCANNED Permit Number: v BY 13 St. Lucie County Building Permit Application 40p Planning and Development Services pP '1 Build and de 23001 Virginia Aovenue9Fort Pieulation rce FL 34982 vision S9J4 4�/c ,°�,�'9 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial ResidentiaW", PERMIT APPLICATION FOR: Renovation III Address: I O U �I4 S. QC_(f-c r' z r i 8C3c o n p. Ct-j- Legal Description: ��t' Wtr�d� Ul(1�rS�sr, ��� ✓7-S'CS1-- Property Tax ID#: 2-8U4-0C)-(2:)00- 15 Lot No. Site Plan Name: Project Name: lC�XG1l- I Setbacks Front Back Right Side: Left Side: NXINFIERNIN WIN. Block No. e errormea unaertnispermit- Ga3 Tank Plumbing cnecKan apply: Gas Piping _ Shutters Windows/Doors Sprinklers Generator Roof _ _ Total Sq. Ft of Construction: Cost of Construction: $ qz-> � C)ec� S Ft. of First Floor: _ Utilities:nSewer 0Septic Building Height: Roof pitch 'pbIVER�JlES C& TRACTOR: s, NameTl-�Cx-c--,gS C- Name: Justin Thiery Address: 1 bD44. S. 6CPC-c-, \D�- 9C5} Company: Island Kitchen and Bath City:^ca �--��t n his -Ca f`M. State: Zip Code:Fax: Phone No.��Z����Z 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 S2500 or more, a RECORDED Notice of Commencement is required. StJPPLEMEiV ,AL CON;ST UrrT,© LN LAVA t FQRMgyTIfJ'f DESIGNER/ENGINEER: Name: _ Not Applicable MORTGAGE COMPANY: Name: _ Not Applicable Address: Address: City: Zip: Phone: State: City: State: Zip: Phone FEE SIMPLE TITLEHOLDER: Name:_ Address _ Not Applicable BONDING COMPANY: Name: _Not Applicable Address: City: City: Zip: Phone: 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 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 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 recording your Notice of Commencement. ,G9r�f� �y ee V�nature of Owner/ Lessee/ tractoranti tractor as Agent for Owner Sig atur f C =racr/License Holder STATE OF FLORIDA STATE OF F COUNTY OF st wde COUNTY OF st wda The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before me this J� day of 20]a by this `� day of 20by J Justin Thlery Name of person mak g 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 Drivers ucense Produced (Signa ure of N Pubf State of Florida) (Signature of Notary Pu %Mf.Florida ) Comm ion N e ^'uQd(Seal, MICHAELRAtZ Commissio o. °` ^ `6� MICHAEL RAAZ + . kS&@*ISSIONdFF904l40 * * MY COMMISSION it FF 9041 EXPIRES: July 28, 2019 EXPIRES: July 28,2019 + OF Bonded lhru Budget Not3nsmices BondedThsu Budget Notarysery REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17