HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:�a1 SCANNED Permit Number: `q \OS-orz 1
BY
St. Lucie County
Building Permit Application RECEIVED
Planning and Development Services MAY 2 3 7.019
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 6E u y, Permitting
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial, —ST. Lt1R d nta
PERMIT APPLICATION FOR: Renovation — O y\ Okz\
Address:
Legal Description: The Princess of Hutchinson Island- A Condominium Composing a part of N 112 of section 2 township 37 Range 41 all MPD in declaration of Condominium or 626-2567
Property Tax ID #: 4502-610-0000-000-6
Site Plan Name: Princess Condominium
Project Name: 19061-Princess-LR-SR-B-K- Princess
Setbacks Front Back: Right Side:
Left Side:
social room kitchen remodel l i�5t�()rn9 netd oT h wu-s p I Gw N u In 9 I CO'Iry 'r
Lot No.
Block No.
fMUUI UUI Id1 WU1 lL LU UC IIUI II ICU UIIUCI UIID FJCI I I I I L—Id ICL.R d I I dppfy:
1:1HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
Electric 0 Plumbing Sprinklers ❑ Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 30,000.00 Utilities:n Sewer ❑ Septic Building Height:
C1U1iER LESSEE
CONY "\Fl.
RAGTi R . 1.
NameJW PriWO15S�
Name: e -
Address: �51r_yk1J os rpar, Dr.
Company: Island Kitchen and Bath
P Y�
City: -Splt- e n li3l c i
Zip Code:'34957 Fax:
Phone No. -12- 2-'Zq - GllO�-tC)
State: FL
Address: • C)Ca G fl 7r1N�.
;c5�
City: -�nspn t ewy) State: FL
Zip Code: 34957 Fax:
Phone No. 772-678-8219 - 772-237-7348
E-Mail: N/A
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
It value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:
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 inspe If you intend-o-gbtain financing, consult with lender or an attorney before
commencing wor re dine vour Didfied of Commencement.
i
Signat a of Ow er/ Lessee% ntractor as Agent for Owner
Sig atu of ntra r/License Holder
ST TE OF FLORIDA
STATE OF ORIDA
COUNTY OF St Luae
COUNTY OF St Lude
The for Ang instrument was acknowledged before me
The for oing instrument was acknowledged efore me
-[by
thisix day of 20� by
this day of 20 I
'A) L42
-I F
Jusiin Thiery
Name of 6erson ma ng 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 License
Produced
(Sig ature of N Pu tate of Florida)
(Signa re f Notary Public- Stat Florida )
io`"'�: � MICHAEL RAAZ
ve
r;••.a�� MICHAEL RAAZ
Commission No. MyCO(Anft6FF904140
Comm t 5 3 1 U T r I I ro. . * MYCil(�' ION@FF904140
EXPIRES: July 28, 2019
E�xppIRES: July 28, 2019
Nl9TECF F�C�t Bordud lnru0ud;atNe:�ry SeK::
~lP0➢F�e�e Berried Urd Budget Wary Senke
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
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DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17