HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI":--kCt_`12—V�1_�n
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5'231\g SCANNED Permit Number: 1Qd5'dColl
BY
St. Lucie County
Building Permit ApplicatioLCRECEIVED
Planning and Development Services MAY 2 $ 2019
Building and Code Regulation Division
1300 Virginia Avenue, Fort Pierce FL 34981 uie Coun j Pgrmltting
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial_ -
PERMIT APPLICATION FOR: Renovation - C (Nv, a r
Legal Description: _lSl�di Cn ( l CX1r,tUtf Ylli'l l V.rv� �/t ! k C)
Property Tax ID #45ca -1yo 1- OU44 -C )O p -V Lot No.
Site Plan Name:
Project Name: I` klj }/r li_�
Setbacks Front Back:
Right Side: _ Left Side:
Block No.
�j� ` evz ivn Demo exlstlny lcttaun Cublmes %4-0 top5 ct"no
pmstlnq (Puli-rG I�0C��t n ordrllllny Into eXtStlr`c3 COnC5 will VIePer(�rmeci
Roush ' tzr)cl u�5tat slx GIs as shown. In Gu ntw gyP"Syr boccf'cl , NVO
Tank UGas Piping
Electric I -I Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $6�
Shutters ❑ windows/Doors
Generator Roof = Roof pitch
S Ft. of First Floor: _
Utilities: Sewer 0Septic
Building Height:
I t._ t z fi k ,ht , t �� ......." � mti
CONTRACTOR , , a c, z.
Name
Name: Justin Thiery
Addr`es�s: O
Company: Island Kitchen and Bath
Citv:�KK150.r-) aQra R/lam Stag_
Zip Code'J,t1A�� Fax:
Phone No4(I )\ -F52-z, - 544 R2
Address: 10875 S. Ocean Drive
City: Jensen Beach State: F L
Zip Code: 34957 Fax:
Phone No.772-678-8219 - 772-237-7348
E-Mail:V�W'
T
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Maii: jthieryikb@gmail.com; nblaszkaikb@gmail.com
II State or County License: CBC1259508
If value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
SUPPLEIV�ENTAL"COM'"UtT6
-F en.s.,.., €
LIEN LAW"INPQRMAIION
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DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY
N a me: Justin Thiery
_ Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City: Jensen Beach
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address: 1ee75 S. Oman 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 our Notice of Commencement.
Si ature of Ow r/ Lessee/Contractor Agent for Owner
tgnatu o ractor/License Holder
STATE OF FLORIDA
TE OF FLORIDA
COU NTY OF st u;cie
COUNTY OF sc wue
The forgoing insument was acknowledge before me
The fo oing ins ment was acknowled before me
this day of 201 by
this day of V� ( 20 by
,I
b AVkAr-'\
Justin Thiery
Name o person making st to ent
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 License
Produced
(Signature of Notary Public- $}�a�adfcfictg�dta,, MISSIONM
y(Signature of Notary Public -State ' 1. °-'-
MVCO'I"ISSION5FF,
61Yu S Jub ppt9
8 20`1
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.Oj EXPIRES:July28,2
Commiss'Boeo�t.NBodogtarysent.et
F°
Commission I11
for RondeC Thtu Budget Notary
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17