HomeMy WebLinkAboutBuilding Permit Application Jul 131507:36a Honest Air, Inc. 772-232-1118 p.1
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q C�
Date: / ��✓ Permit Number: �) JG J
s
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercia I Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION: .;
Address: A
qakl/� 0 Olt
Legal Description: ev ;koc (f~ W
L
Property Tax ID#: 3 ' Q Lot No. q.
Site Plan Name: _ A tti r, Black No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED.DESCRIPTION OF WORK:..
&NAfeT 41AZ.7 A116 V5716-Al Id rff /VZW'
CONSTkUCTION.IN FORMATION: .
Additional work toe e orme under this permit-check a appy:
HVAC E]Gas Tank ❑Gas Piping _Shutters a Windows/Doors
QElectric E]Plumbing Sprinklers El Generator F Roof
Total Sq.Ft of Construction: )) 5Ft. of First Floor:
Cost of Construction:$ + r7`-�, Utilities: Sewer Septic Building Height:
OWNER/LESSEE-.: ` CONTRACTaR;
Name
Name:
Address:
Address: 01c 9 Company: 1 ,V& .
City: T• State: Address: A
Zip Code: Fax: City. [y _ Stater
Phone No.�72 ' `7� S- Zip Code: Fax:
E-Mail: Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail: 11 ' S vit'I ,i1s
from the Owner listed above) State or County License: '
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
Jul 13 1507:36a Honest Air, Inc. 772-232-1118 p.2
SURRLEI�IIEIVTAL.CONSTRUCTION:LIEN LAW INFQRMATIOt11:.
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 finahicing,consult with lender or an attorney before
commencing or recordi4g yourrecord' NoticeCommencement.
Aa//
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_//4�' JA_
_Signature of wner/Lessee/Agent Signature of Contractor/l%--; Hof r
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Aoe� COUNTY OF J441.11
The for oing instrum w,as acknowledged 4efore me The for oing instrument was acknowledged before me
this, dayaf J L�7 . 20 �by this ��day of 20 })by
AVOW
(Name of person�knowledging) (Name of person acknowledging)
/r ;
(signature of Notary Public-State of FI rida) (Signature of Notary P-ubJIc (e of Florida-)
Personally Known .Y OR Produced Identification Personally Known OR Produced"Wentrfication
Type of Identification Produced Type of identification Produced
ICHAELWHATELEY
Commission No. .'1 ly j.�• � H L�LE�' Commission No. .?1Commi( )FF 011647
r ;+= mmissi 0111647 ^� Expires April 24,2017
Expires Apol 24,2017 ea emm,t�r Feip Ing-=erosasowo
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS