HomeMy WebLinkAboutBuilding Permit Application Feb 041611:24a Honest Air, Inc. 772-232-1118 p.1
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date' ' ( Permit Number: ( o� 'LA i
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....._ .. .:.. - - Building Permit Application
Planning and Development Services FEB m 4 2016
Building and Code Regulation Division
2300 Virginia 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 line
PROPOSED.IMPROVEMENT LOCATION: ' ..
r
Address:--d � �: QC64,U JDJ2 It W
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Legai Description: q X01
Property Tax ID Lot No.
Site Plan Name'_ JI n4 61 6�'1,c�i —vu __-._. Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION:OP.WNORK:
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CONSTRUCTION-INF6.13MATION:
itiona war to [ e rme urider t is permit check a IFthat appy:
®HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
Electric Plumbing Sprinklers i I.l Generator E]Roof
Total Sq.Ft of Construction: �) S Ft.of First Floor:
Cost of Construction:$ 36--,)7.
/ ` l,- �" Utilities:OSewer Septic Building Height:OWNER/LESSEE:. CONTRACTOR:
Name �`»� : ire LIfN y Name: f •
Address: i E�7r 5��S. QaAt,?69= 7Pr��`7 Company:
City: � JL� � State: Address: 1173 S e
Zip Code: .39q!7Fax: City: c� State:
Phone No. '7 a 1 ' /2t" 00S Zip Code: ���!/� Fax:
E-Mail: Phone No. 772 �Ll _
Fill in fee simple Title Bolder on next page(if different E-Mail: llfriV .AIC—
from the Owner listed above) State or County License: :;"43
If value of construction is$2500 or more,a RECORDED Notice of Commencement Is required.
Feb 041611:24a Honest Air, Inc. 772-232-1118 p.2
SUP.PLEMENTALCONSTRUCTI.ON IEKIAW INFO} MATl.ON:.
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Dame:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE BOLDER: _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 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,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
mendmentsThe 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 payingtwice 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
commencing rk;or r cordin r Notice of Commencement.
4t/014� — -t
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_Signature of Owner/les a Agent Signature of Con ctor/Li r
Holder
STATE OF FLORIDAhJ STATE OF FLORIDA
COUNTY OF COUNTY OF
The for oing lnstrumen w acknowledge before me The for oing instrument was acknowledged before me
th is day of 20 by this day of a ,20 by
14
(Name of person ac dging) (Name of person acknowledging)
A
(Signature of Nota ublic-S to of Florida) (Signature of Notary Pub' -Stat of Florida)
Personally Known OR Produced Identification Personally Known Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. i5e (Seal) Commission No.
CHRIS WOMBERRY CHRIS VYOODBERRY
_•: ommission#FF 908943 -'
Revised 07115/2Expires August f2,2019 s; }ws Wires August 1P,2019
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
DATE R
COUNTER REVIEW REVIEW REVIEWEVIEW REVIEW REVIEW
COMPLETE
INITIALS