HomeMy WebLinkAboutBuilding Permit Application Dec 3015 01:54p Honest Air, Inc. 772-232-1118 p.1
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �7
Date: n. j Permit:Number:
- Building Permit Application
RECEIVED
Planning and Developmenrservices DEC 3 0 2015
Building and Code Regulation Division
2300 Yrginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of fine
PR:O'POSED IMPROVEMENT'LOCAT-10M
Address: /� p d� ���- t (1
Legal Description: (, �f Z ! LT7' T�( � �'V L� 7 000
Property Tal(ID# Ll SOel;t- QX 1 00 Gt ODO Lot No.
Site Plan Name: �� �� �,� 42T1Ajo Block No.
Project,Narne:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF:.WORK:
K f A/C S`f
CONSTRUCTION INFORMATION:
-Aaclittona workto e e Orme un er t is permit-check a appy:
®HVAC Gas Tank ❑Gas Piping _Shutters a Windows/Doors
0 Electric. M Plumbing Sprinklers Q Generator Roof
Total Sq.Ft of Construction: !! S Ft.of First Floor:
Cost of.Construction:$ �� t Utilities:11Sewer Septic Building Height:
OVIWNER/LESSEE: CONTRACTOR- ..- '.*: '
Name Name:
Address: f..f:�Ci� S.� QCG�' 012- Company: u T A/C
` 3 73 91(A)City: � [-,nJ MAW State:� Address:
Zip Code: 'W9 5�2 Fax: City: Stater
�
Phone No. -77 ' 2A - 222 7 Zip Code: W990 Fax: 7 `439 AT
E-Mail: Phone No. _
Fill in fee simple Title Holder on next page(if different � E-Mail: V S Cu r..c��
from the Owner listed above) I State or County License: JK ,20613
If value of construction is$7500 or more,a RECORDED Notice of Commencement is required.
Dec 30 1512:19p Honest Air, Inc. 772-232-1118 p.2
SUPPLEMENTAL.CONSTRKTION LIEWLAW INFORMATION:..:
DESIGNER/ENGINEER: T Not Applicable MORTGAGE COMPANY* _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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:Yourfailure 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. I you intend to obtain financing,consult with lender or an attorney before
commencing wo your Notice of C mmencement.
•� 1 `
s
—Signature of Owner/LesseeJAge Signature of Con ra or/Licen der
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTYOF
The foroin instrum nt s acknowled ed before me The f rgoing instrument was acknowledged before me
this Qday of 20 L(Llby this W. day of .20 X:'by
Ww- AM Ci-I
(Name of person acknowl g (Name of person acknowle )
(Signature of Notary Public-State o Fiorid (Signature of Nota=ic-Sta lorida)
Personally Known OR Produced Identification Personally Knowned Identification
Type of Identificatiio(n'Produced Type of Identification Produced
Commission No. 1 t 0 r �1 le-111
Commission No. 7V 6
, y^ C OMBERRY CHRIS%VOODBERRY
Commission 9 FF 906943 Commission#FF 906943
piras August 12,201ki ;; 0. Expires August 12.2019
Revised 07/15/2014 BaAtetlThtirmyFenlnsuttnceB7038&TtltE ' (,nua9mtmrKa hsrattl8h0�CFft11
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATfON SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS