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HomeMy WebLinkAboutBuilding Permit Application Dec 15 15 10:00a Honest Air, Inc. 772-232-1118 P. ALL APPUCABLE INFO(MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: .' IS Permit Number. RECEIVED wilding Permit Application DEC 15 2015 Planning and Development Services PER!A ITTI NG Building and Code Regulation Division St. Lucie County, FL 2300 Orgfnia Avenue,Fort Pierce FL 3498.2 Phone:(772)462-1553 Fax: (772)462-1578 Commercial ReSidential _ PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address 101 51 o(LIJ2 89 Legal Description: 111 131 )2 _ i4 Property Tax lD#: I All " d05 F° �0© ' Lot No_ Site Plan Name: 5 f 6U_,t ' --41 6EA �f�t v'?�!' '7�° L/Cl VW-6 Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: Z-19Cr-ox ASC .r CS i/T W 77 CONSTRUCTION INFORMATION: Adclitional work toa orme under is permit—c e a appy: HVAC E]Gas Tank ❑Gas Piping _Shutters a Windows/Doors Electric 17 Plumbing Sprinklers Generator Roof T otal Sq. Ft of Construction: 5 Ft.of First Floor: Cost of Constriction.$ �S Utilities:0SewerOSeptic Building Height: l OWN ER/LESSEE: CONTRACTOR: Name /l Name: ,�1� 6L1 Address: /n P�1?-� Company: D lr[!� Jve_ City: 2j!49!U& ✓!� State: ✓ Address: q tcl Zip Code: _ Fax: City: ,�41 Stater Phone No. � .2 4- 'X/C' -9,2 Zip Code. 0 Fax. elf '93/; J' " E-Mail: Phone No. Fill in fee simple Title Holder on next page(if different E-Mail: from the Owner listed above) State or County License: c lttr If value of construction is$2SOO or more,a RECORDED Notice of Commencement is required, Dec 151510:00a Honest Air, Inc. 772-232-1118 p.2 SUPPLEMENTAL CONSTRUCTION.LEEN LAW INFORMATION DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: _Nat 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 thepermit 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,1 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 commencin work or recording our roti of Commencement. 1 rr s _ Signature of Owner/Lessee/Age t Signature of Contra pr/ items der STATE OF FLORIDA L STATE OF FLORIDACOUNTY OF COUNTY OFAv2iiv- The for oing instrument was acknowledged before me The fo ping instrument was acknowledged before me this day of ©f'a tl 'F?. 20/�by this L5 day of D6 C?g4a 2 ,20 15 by Amb (Name of person acknowi dging) (Name of person acknowledging) _ I (Signature of g6tary Public- to of Florida) (Signature of Notary P tic-State o_fAdrida} Personally Known OR Produced identification Personally Known _0# Produced Identification Type of Identification Pr6duced Type of Identification Producelci Commission No. ) Commission No. � ,} (Seal) k CHRIS WOOOBERRY Commission 4 FF 908943 �"�"•"',' CHRIS wooDSER Expires Aug,4112,2019 " Stun' ion*FF�908943 Revised 07/IS/2014 � P ^+ °nom�TRry Frn tnsus%tBA85749 �S Expims August 1C �� lonewrhv> 2019 eN 41A:n4fYgf�+�70k4 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS