HomeMy WebLinkAboutBuilding Permit Application To:St. Lucie County Building Dept Page 2 of 9 2016-10-12 18:48:22(GMT) 18666845854 From:Scott Hixon
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/12/2016 Permit Number:
CSI''-DOT _2 i.Or6
L � n
k
.. ,. Building Permit Application
Planning and Development Services
Building and Cade Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-5553 Fax: (772)462-1578 Commercial Residential x _r_
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
:^3`
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 I D It: 4436-510-0030-000-6 Lot No.
Site Plan Name: Block No.
Project Name: Johnson-13395=-
Setbacks Front Back: Right Side: Left Side:
S
1
a/cchange out no duct wor�
Kin72
fir'
t.-
�
Additional work to e e orme un er is permit—c ec a appy:
L�1HVAC 1I Gas Tank ElGas Piping _Shutters []Windows/Doors
Electric 0 Plumbing Sprinklers 0 Generator Roof Roof pitch
Total Sq.Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 6,329.00 Utilities: Sewer OSeptic Building Height:
i'
S }L
}
Name JOHNSON Name: WILLIAM S.HIxON
Address:3354 NW PERIMETER RD Company: W.S. 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
Fill in fee simple Title Holder on next page{if different E-Mail: airplusfl@yahoo.com
from the Owner listed above) State or County License: GAC-1816064TA
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required. 3()
To:St. Lucie County Building Dept Page 3 of 9 2016-10-12 18:48:22(GMT) 18666845854 From:Scott Hixon
v y
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: _ City:
Zip: Phone: Zip: Phone:
I certify that;;o 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 Oran 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 your Notice of Commencement.
William Scott Hixon William Scott Hixon �•�-•wnN.. S
Signature of Owner,Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF MARnN 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 j this " day of oc'oeER 20 16 by
WILLIAM HIXON i WILLIAM HIXON
(Name of person acknowledging} (Name of person acknowledging)
Sigriat re of Notary ublic-Stat a � (Sign tui of r 'M lic- 6"P&x ( R C 'e°ri ^p
Personal! o dit �i��I on Personally lino Oak ti lfion
68NICO�O
Type of ldn=#4c tI�sr'.p o p itii�5 p Type of Identifi d ;r ►tiuG�e . rto-an I
' AnplFeS r N1CP,AQCri i 071390.5153
CommIS510 Fp c�7 05 �«tsas ealj Commission No. 3 (Seal)
th571'39
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
IfVITIALS