HomeMy WebLinkAboutBUIILDING PERMIT APPLICATIONALL APPLICABUMNFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: as \`� SCANNED Permit Number:
BY RECEI
St. Lucie County
Building Permit Application APR 2 2 2,1Jq
Planning and Development Services ST. Lucie Count_ yPorrn
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Renovation - C, c ,^
� PRCI 6S IMPROWMENT.LOCATION.
Legal Description:
Property Tax ID t#:
Lot No.
Site Plan Name: y0 6 -e-- Block No.
Project Name: i I:RZ.C,J3- 10 CA-AW-
Setbacks Front Back: Right Side: Left Side:
X`Vtoi5-terl r�,r�eua-t~ (an- coca ic�G� c�eaeelcw� Cz� l e .c� 5, tv; r
eka. rV- , r-e��.a-e.� rr,csiCg�
L_I Shutters
Generator
Windows/Doors
L� Roof
Total Sq. Ft of Construction: Sct. of First Floor:
Cost of Construction: $ 2�, f�0 G Utilities: Sewer DSeptic Building Height:
0' So
RJL�SS�E'¢'
CONTRACTOR. ...:
Namennp,,rito, T.
Name: Justin Thiery
AddressP190CD S C)Coa>. Z - 4 L OO Lo
Company: Island Kitchen and Bath
City �.C, (3n aAtA- State:%
Zip Code:?A11�t-5__I- Fax:
Phone No. 21G -'o 5- 16---+ G
Address: 10875 S. Ocean Drive
City: Jensen Beach State: FL
Zip Code: 34957 Fax:
Phone No. 772-678-8219 - 772-237-7348
E-Mail:CQ q
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: jthieryikb@gmail.com; nblaszkaikb@gmaii.com
_
State or County License: CBC1259508
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
t
.So 0Ili ART-M, CONSTRUCTION
LjEj1t lAW INFORMATION
"' `
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name: Jusun Thiery
_ Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City: Jensen Beach
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address: 10875 S. Oce.n Drive
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 vour Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
or/License Holder
Sitn!ailidEVLORIDA
STATE OF FLORIDA
STATE O
COUNTY OFSiwde
COUNTY OF StLuue
The forgoing instjument was acknowledged before me
The forgoing instr^ne�nt was acknowledged before me
this day of LAP ✓) 1 . 201g by
this l/l( lt.day of ;
'�"-"
1 . 20� by
'
Jusun 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
Produced Drivers tieense
Produced
(Sign ture of N Pu lic-State of Florida)
(Signature of Notary Pub'
a of F rida )
5aae °aa
Commy°;•'•• a MICHAELRAAZ
issi
Commiss'
MICHAELRgAZ
*M�CONIMISSIONIFF9041
0 a � EXPIRES: July 28,2019
* MYCOMMISSION8 FF0041
a �.,o�`O BoMedThruBudgetNourySend,s
o� EXPIRES:JuI
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17