HomeMy WebLinkAboutWINDOW/DOOR INSTALLATION RESIDENTIAL ALLAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 0 (07L?
Building Permit Application RECEIVE®
Planning and Development Services
Building and Code Regulation Division JUN 3 0 2017
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 od I USS
PitOPOSEDIMPR01/EMENT
Address: 7106 Eden Rd.
Legal Description: Lakewood Park-Unit 12-BLK 165 Lot 5 (Map 13-12S) (OR 3769-2096)
Property Tax ID#: 1301-614-0193-000-1 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORRMY ' y
replace 1 window size for size
CNSTRUCTION INFORIUTATION .,
. ._..
Additional work toe e orme under this permit—check a t appy:
HVAC Ei Gas Tank 0Gas Piping _Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 1259.00 Utilities:cn Sewer 0 Septic Building Height:
OWNER/LESSEE CONTRACTOR
Name Dean Paton Name: Raquel Swanner
Address:7106 Eden Rd. Company: The Home Depot
City: Fort Pierce State:FL Address: 6500 NW 12TH Ave. Suite 110
Zip Code: 34951 Fax: City: Fort Lauderdale State.FL
Phone No. Zip Code: 33309 Fax:
E-Mail: Phone No. (754)224-2010
Fill in fee simple Ti older on next page(if different E-Mail:
from the Owner listed above) State or County License: CGC1514813
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTCORU
; AL NSTCTION LIENgLAW INFORMATION
77
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 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: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 financ' ons t with lender or an attorn a re
com work or r cor in r otice of Com ncement.
SignaturVFLrRIDA
see Ignat re Contracto /Licens Holder
STATE STATE OF FLORIDA
COUNTY OF COUNTY OF.
The forgoin instrument was acknowledged before The forgoing instrument was acknowledged before me
me this ( day of )(A^-L- , 20 17 by this day of 20_17 by
l �&Awt av,,Me 9"n, '
(Name of person acknowledging) (Name of person acknowledging)
'(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. _ �n� •- " mmission No. Seal r.
r—r TIMOTHY R.G MALLEY
��g••�:A• I ,•;'�:+'.>N''• TIMOTHYR.OMALLEY
i�I,;=q.•!f' `°= MY CGta11,41SS10N 4 FF 042794 r ,•_¢• mac MY ,
iMisginN 4 FE 049724
.' zlz EXPIH :August , )u ` ` EXPIRE:August 7 2017
Underwriters Bonded Th u Nota
Revised 07/15/2014 Bonded Thru Notary Public
�'+; = Notary Public Underwriters
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