HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: % /- / 9 SCANNED Permit Num
BY
t t a„' Wq St. Lucie County
Building Permit Ap
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
JUL 16 2019
Permitting Department
St...Lu __:A_ Luc(e County, FL
PERMIT APPLICATION FOR: Renovation I
Legal Description: (`yan(Dy-eS S I ayat-17 K044
Property Tax ID It. "�G 2_-- 1, o%G -
Lot No.
Site Plan Name:(^��k,6 CD Block No.
Project Name: Igo 06-
Setbacks Front Back: Right Side: Left Side:
.,iiai WVIN w ua
Fp
Electric
ai
wi IWU wwel uuo perrnu -cneCr au apply:
GG Tank Gas Piping _ Shutters ❑ Windows/Doors
Plumbing Sprinklers Generator Roof
L_I
Total Sq. Ft of Construction:
Cost of Construction: $ 6 !� 107.>
S Ft of of First Floor: _
Utilities: l _J Sewer Septic
Building Height:
Roof pitch
01ft1lVER%LS��E:'a°``a[ONTRACTOR
'r c
Nameyr'4(2Y� G) L.fs 6
T
Addr s - !aI 60 S O(XJQCT (,fir JgfA
Name: Justin Thiery
Company: Island Kitchen and Bath
City: �Q/y, �4 Gi.P�L-� Stated
Zip Code: 9ES--2= Fax:
Phone No.452G-7.42-1to2'�
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: jthieyikb@gmail.com; nblaszkaikb@gmail.com
State or County License: CBC1259508
it vame or consrruapon is >zsuu or more, a RECORDED Notice of Commencement is required.
SUPPLEIVIEfUTALRCONSTRUCTION UEN`LAW[iNF,O,RMATION
`
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 TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY: _Not
Name:
Applicable
Address: 10e75 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. y
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 f''rsyiq�p�¢tion. If you int d to obtain financing, consult with lender or an attorney before
commenclfier4✓dck df recording voffr Notice of Commenrempnt_
Z 2A
r/License Holder
S�ig=reoVRIDA
Si ure of w r/ Lessee/Contractor as Agent for Owner
STATE O FLORIDA
STL
COU NTY OF St wue
COUNTY OF Sr. wa°
The forgoing insSMjum��en��t acknowledg before me
The forgoing inst ment was acknowledged before me
�was
this J� day oiIAf jI .20"_ by
�ic�AkAO '�
this �day ofyi k 20� by
,V
Jusdn Thiery
ome 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 Driver; Lleense
Produced
%
°(Signature of Notary Pub' a of Florida I
` (Signature of No! ic- a of Florida I
psY aua" MICHAEL RAAZ
Commission * My(SkJJs SIONIIFF904140
°
Commiss' No I MICHAEL
MYCOM�115510N#F
EXPIRES: July 28, 2019
*
EXPIRES: Juty 28,
orr,d, BondedThmBudget NotaryServaes
y' Bonded Tlw BudgMNaia
ep°`
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ZONING
SUPERVISOR
PLANS
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SEA TURTLE
MANGROVE
COUNTER
REVIEW
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DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17