HomeMy WebLinkAboutBuilding Permit Application Oct 19 15 08:57a Honest Air, Inc. 772-232-1118 PA
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: R1 0
RECEIVED OCT 192015
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)462-1579 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT"LOCATiON:
Address: 06MAJ bW 4116
Legal Description: &96 Mi //z 13-`, 77 h
q, �)I q CCO-7
Property Tax ID#-- . Lot No.
A; - O—
Site Plan Name* e&"9A Block No.
Project Name:
Setbacks Front_ Back: Right Side: Left Side:
DETAILED DESCRIPTION"OF WORK:
if-/ IItk*C- 'IS 7Z;41
4�k —
L"'Ir'Ull
kW
CONSTRUCT-ION--INF ORMATION-
AcIditionalworKtOloe effo-rmed under this permit—cheCK all Mat appy:0HVAC nGasTank F 1Gas Piping FIShutters a Windows/Doors
Electric F]Plumbing OSprinklers 13 Generator l=J Roof
Total Sq.Ft of Construction: S, Ft.of First Floor
Cost of Construction:$ Utilities: Sewer OSeptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Name: a/
Address: —,!UT
—Jo UO 5 6&AW Dk company: May
MAJ I" sp
City: 6!� State- Addre
Stater
Zip Code: Fax: City: St a
Phone No Zip Code: Fax:
E-Mail: Phone No. ?,;t `JJ1�4
Fill In fee simple Title Holder on next page(if different E-Mail: +U . &JKg2eAQ C—C V?71.w r
from the Owner listed above) State or County License*.
if value of construction is$2500 or more,a RECORDED Notice of 'n rnm enrenne nt is required.
Oct 191508;57a Honest Air, ino,
772-232-1118 p.2
SUPPLEMENTAL'CONSTRUCT.I0N11I N LAW INFORM. ATiON:.
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: Cly•
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 exemptfrom undergoing a fuii 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 I der or an attorney before
,commencing wxkk recording aur Notice of Commencement.
s
_Signature of Owner/Le j nt Signature of ontractor/Lic der
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The for ing instrument acknowledged before me The for oing instrument was acknowledged before me
this day of __ l 'tom. 20 15-by this day of_ 0C1VWk .20 jf7by
A 2 � G.
(Name of person acknowledging) (N�a teeoof person acknowledging)
(Signature of Notary blic-State of F da) (Sign ure of Notary P lic-Stat of Florida)
Personally Known - 'OR Produced identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. ••••'° Commission No.�lIr-:*9_!'V (Seal)
,�:• ERRY
COmmiSSIon#FF 908943 ,a;. rit'.i CHRIS NIX7DBERRY
,� �° ugus 2019 =•: 0 FF 908
.P, •• 8aadadlhttrTrrnF.Wormrawe*C M.7p,q EXplresAugust 12,20'19
Revised 07/15/2 # 8*,We;lstrrTfNFantumfte10M"IS
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS