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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /� 1 `�, �' tM- Q Date: SCANNED Permit Number: 1TI BY St. Lucie Countv RECEIVED Building Permit Applicatio Planning and Development Services AUG 0 7 2019 Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 IR.` ST. Lucie County, Permitting Phone: (772) 462-1553 Fax: (772)462-1578 commercial \ UN`N e51 en is PERMIT APPLICATION FOR: Renovation Address:(f�; i C x !L) r CS l 34 1 Legal Description: 1S,�1�1C.�iG�v��C�yv� �y� Llvli t ryU Property Tax ID Lot No. Site Plan Name: 19012- Block No. Project Name: I C;'101,2 — ��iy1�lG Setbacks Front Back: Right Side: Left Side: %�Gnava �rM . �,na i �irn"�, y d t� Gu63� +S, Ole,-�ol Additional work to e erformed unclerthis perm — check all that a OHVAC ppy: ❑Gas Piping ❑Windows/Doors _Shutters ��GasTank .Electric Plumbing Sprinklers ElGenerator 0— Roof Roof.pitch Total Sq. Ft of Construction:: S'c Ft. of First Floor: y Cost of Construction: $ `j D, Utilities., Sewer 0Septic _ Building Height: Name(A %kwC'v r\ Name: Jusnnmiery Company: Island IGtchen and Bath AddressI`--N�U S Qco Gr-\ br +�60i City:,\-WS4.V\ is o QaM State:. Address: 10875 S. Ocean Drive City: Jensen Beach State: FL Zip Coded Fax: Phone No.—T12—Z"S 1-1 kF Zip Code: 34957 Fax: E-Mail:�j A _ Phone No. 772-237-7348 772-678-8219 Fill in fee simple Title Holder on next page (if different E-Mail: ithieryikb@gmail.com, nblaszkaikb@gmail.com State or County License: CBC1259508 from the Owner listed above) If value of construction Is $2500 or more, a RECORDED Notice of Commencement is required. Address: City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: _ Not Applicable Address•+0875a-0cean City: Zip: Phone: MORTGAGE COMPANY: _ Not Applicable Name:J­tnT^'e,y Address: City: Jensen Beach State: Zip: Phone: BONDING COMPANY: _Not Applicable Address: City: Zip: Phone: CONTRACTOR AFFIDVIT: Application is herebv 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. 4v Signature of Owner/ Lessee/Contractor as Agent for Owner Sig to on actor/License Holder STATE OF FL I A 5 ATE O F RID COUNTY OF c A�.N aE COUNTY O nAn�2 The f oing instrument was acknowledged before me The f r oing instrument was acknowledged before me this 4ay of - 20Lq by this day of� 26Aby Name of person making statement Name of personj�akin tement Personally Known OR Produced Identificationy Personally Known ✓ OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature o a lic-State of Florida) R (Signature of ary Pu ' -State of Florida) n •r•• Co o.0pG6318620 CO Isslo fir, ICHAELRAAZ ••'• (SEaI • �aaj*28.2023 ° . • cumrawon900318620 � resJ*28.2023 �3 y gppettaen Ban REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17