HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONA
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5 a3 SCANNED Permit Num
BY
St. Lucie County
Building Permit Applicat
Planning and Development Services
Building and Code Regulation Division .
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT APPLICATION FOR: Renovation
Address:
ber: 1 `\d 5-a Co 0 `d
F
IVED8 2019
a Par(Timing
Residential X
Legal Description:
F►`l�/. Lid_ ..� i �iV�rl``�+ i�i�iT�rs� u
.l• r s ♦►•
Site Plan NamE
Project Name:
Setbacks Front baCK:
tugnt bide: Lett Sloe:
rJ� I/ CaI�Po d : V I1taVd)M b exls-ha I � f cunt Drew cei It n y • peowe pact -Him
J 01 s to boilw.� 1 IT15WI helm drIvlrclU aS nf,Z edl Install tuw ca)dl s, tops , e&(_
vlRS r Ixdrpv :demo eKiOny, lrIN11 ►Uw Sc ey° sytem In shovvw rnclude,s HDOr, tiufb w4lls-
nStG(I true) tale I lab,rt ct 5 = toi�3 tl e fylace anI wq a aS Aeed,cd. (�ucJt32: Ocnw eXlst1ng install
n n•1111 e..h l..l.v ll 4lein.. •.. ll. Alnn. .nrir=ltri nJnn! /,e d=.. .Mnll, a•! loll nil N,u1 .r. •. _1-.v.— ..
❑HVAC L-1 Gas Tank ❑Gas Piping
_ Electric [?Plumbing ❑Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 126� BBO
Shutters ❑ Windows/Doors
Generator ❑ Roof = Rocf pitch
S Ft. of First Floor: _
Utilities.
Sewer ❑Septic
Building Height:
OWNER/LESSEE F` h 1; A�`6 =l$.1 °?
u(�)�rV�i�
CbNTI�AGlOR
.,.O Y n .
Name 40o --ta
Name: Justin Thlery
Address:`RFStSU S. Gnor� It r C)
Company: Island Kitchen and Bath
Cityt Cam State: EL
Zip Codey�C�75-}- Fax:
Phone NO.-40SS -SZ lo- S4-4-4-
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 $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLENjjUALGONTRUCII#?lVL{ENLAVIIINFORXM/TI(7lV`A
1£lmke'„# i{zu
3G;,,b .a
DESIGNER/ENGINEER:
Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name:
N a me- Justin Thiery
_
Address:
Address:
City:
State:
City: Jensen Beach
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER:
_ Not Applicable
BONDING COMPANY:
_Not Applicable
Name:
Name:
Address: 10875 S. ocean 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
commejidnig—work or recording vour Notice of Commencement.
Q�im S c&'
Y
Signature 01 Owner/ Lessee/Contractor as Agent or Owner
S' nail a qF ontra or/License Holder
STATE OF FLORIDA
ATE O RIDA
COUNTY OF sc wue
COUNTY OF stwae
The for oing inst ment was acknowledged before me
May
The for oing inst ment was acknowledged before me
this day of J 20Jq by
thisZ,W day of�V�\� 20P1 by
( -P(,—y, A
Justin Thiery
Name of person making stat 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 Pub' s Florida)
(Signature of Notary Public- State 4f Florida )
,Va, MICHAEL RAAZ
zn.�'; o e`
2ap�
MISSION f FF 904140
".MISSION
Commiss' o . �f"
Commission No. ,tISSIONitFF904140
HES: July 28, 2019
1 ES: July28, 2019
�"Eorn R Bondedihru Budget Notary Services
"rorrn"sp Borded Thor Budget Notary Services
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17