HomeMy WebLinkAboutBUIDING PERMIT APPLICATIONr
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED Permit NumberTqnig-oj�,%.
BY
St. Lucie County F
Building Permit
AUG 0 7 2019
Planning and Development services sT. Lucie County, j
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
I PERMIT APPLICA:TION FOR: Renovation -1
Address:
Legal
EN
UIIUCI U11b fiermit— cneCK all P34 apply:
Pas Tank []Gas Piping U Shutters Windows/Doors
Plumbing OSprinklers E] Generator Roof Roe, pitch
Total Sq. Ft of Construction:
I
Cost of Construction: S ozx>
=14-
5 Ft ofFirstFloor:
Utilities'll SewerE]Septic
LITY: State:[;��_L
Zip 66dle::���_ - Fax:-
PhoneNo.D-DS (950 LLVL411:�
E-Mail: Y1 10,
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: Justin Thiery
Building Height: _
Company: Island Kitchen and Bath
Addr ess: 10875 S. Ocean Drive
City: Jensen Beach State. FL
Zip Code: 34957 Fax:
Phone No.IL2-�7878210_ - 772-237-7348
E-Mail: ithie'rylklo@gmail-carn; nb1aszkai_kb@gmailcom
State or County License: CBC1259508
construcdon is $2500 or more, a RECORDED Notice of —Commencement is
3
I
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Address: 10875 S. OCeari Drive
City:
Zip: Phone: —
MORTGAGE COMPANY: Not Applicable
Name:Ju"mThery
Address:
City: Jer� Beech ate:
ZIP' Phone:
BONDING COMPANY:
Address:
Zip: Phone:
—Not Applicable
:)WNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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St.LucleCoun makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conWIct 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-permitapplicationsare 4XOMPffrOnuundergoing a fullconcurrency 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
commencine work nr rprnrrlin� ...... hi—+;--
wt
SW4-Adre of Owner/ Lg9see/Offintractor as Agent for —Owner
IgIF ntractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF st L-de
COUNTYOFst�
The forgoing instrument was acknowledged before me
thl� Cida:
The forgoing instrument was acknowledged before me
of �Vv'\- 20 [", by
this to day
— 0111_'���
201 1by
a
J=fin Thiery
,
Name of person making statement
Personally Known _ OR Produced Identification x
Name of person making statement
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced D&em Ucense
Produced
( f(Signature
Signature of a blic- State oof Florida I
(Signature of Nota
te of Florida I
tAy pa
Commis NO. LRAAZ
my cc 'mom 140
Co sslo
HAEL RAAZ
04,SSION#FF90414o
EXPIRES: JU�28,2019
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EXPIFIES:,b�28 201,q
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
PLANS VEGETATION
SEA TURTLE MANGROVE
REVIEW REVIEW
REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLET: E
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