HomeMy WebLinkAboutBuilding Permit Application To:St. Lucie County Building Dept Page 6 of 9 2016-10-12 18:48:22(GMT) 18666845854 From: Scott Hixon
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTER
Date: 10/12/2016 Permit Number:\�1_3 V)
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RECE '''7D OCT 12 2916
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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 Commercial Residential x
PERMIT APPLICATION FOR:
To Select from dropbox, click arrow of the end of line
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Address: 3354 NW Perimeter Rd,Palm City FL 34990
Legal Description: WIDE WATERS S/D LOTS 26 AND 27(OR 1063-2822: 1307-2473: 1429-560;3761-2414)
Property Tax ID#: 4436-510-0030-000-6 Lot No.
Site Plan Name: Block No.
Project Name: Johnson-13395-2
Setbacks Front Back: Right Side: Left Side:
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rt �5.w ,.a ; t t{ i tt �'"c r: ., r�'' {�1..
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a/c change out no duct work
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Additional wor to ever orme under is permit–check a appy:
RJHV,AC 1(_J Gas Tank IlGas Piping —Shutters E]Windows/Doors
Electric LJ Plumbing Sprinklers Generator LJ Roof Roof pitch
Total Sq.Ft of Construction: Sq, Ft.of First Floor:
Cost of Construction:$ 7.811.00 Utilities-0Sewer tn!5eptic Building Height:
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Name JOHNSON Name: WILLIAMS.HIXON
Address:3354 NW PERIMETER RD Company: W.8. HIXON AIR PLUS
City: PALM CITY State:FL Address: 3261 SE SLATER ST
Zip Code: 34990 Fax: City: STUART State:FL
Phone No. Zip Code: 34997 Fax: 866-684-5854
E-Mail:airplusfl@yahoo.com Phone No. 772-486-2002
Fall in fee simple Tatle Holder on next page(if different E-Mail: airplusfl@yahoo.com
from the Owner listed above) State or County License: CAC-1816064TA
if value of construction is$2560 or more,a RECORDED Notice of Commencement is required.
To: St. Lucie County Building Dept Page 7 of 9 2016-10-12 18:48:22(GMT) 18666845854 From:Scott Hixon
�ESIGNE�?/E6�GIr�1EER: 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:
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 apermit 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 financing,consult with lender or an attorney before
-commencing work or recording our Notice of Commencement.
William Scott Hixon r.:FWilliam Scott Hixon =« •«-� .a S
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder�
STATE OF FLORIDA STATE OF FLORIDA
COUNTY CAF MARTIN COUNTY OF MARTIN
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 12 day of October 20 16 by this f2 day of ocroae, 20 16 bs/
WILLIAM-AXON 1 WILLIAM HIXON
(Name of person acknowledging) (dame of pgson acknowledging)
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Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS