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HomeMy WebLinkAboutWINDOW/DOOR INSTALLATION RESIDENTIAL All CABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED J y f� � Date: ° /� Permit Number: / —/ , — ooz7 RECEIVED' .i - - - Building Permit Application JUL ® 3 2617 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 PERMIT APPLICATION FOR: :a .ax,,, 'sly',� a PRD.I'®SEjDINPR01/EMENTLaCA lo `�r � k * ` Address: Legal Description: 7T 1�9 Is-- ► c3a Property Tax ID#: �� to Q o� ' , �� ©` Ci Lot No. Site Plan Name: / Block No. Project Name: C 'v d e-S e&.- / Setbacks Front Back: Right de: Left Side: " y%?` s mak CIRT�RAILED DES�RPNF� . _tHna � aD CONS1'RtJCT(O1V 1NF®RNIA�? ®N v P VAd �. Additionalwork to be pertormed under this permit—check all that appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Construction:__ I� Cost of Construction:$ o(4 V Utilities: _Sewer _Septic Building Height: ®1lUN;ER/LESSEE: � C® 15 ' ra N;fRACTO-RA: Name Name: Address* N 4 Company: City: State::�- Address: Zip Code: Fax: City: State: Phone NZip Code: Fax: E-Mail: Phone No Fill in fee simple Title Holder on next page( if different E-Mail from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. uPPLElti!)EN�' II �L@ NSI t1,CTIi N .( L,4�1N IN fJR,IUiAT N� 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: OWNER/CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. 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 financing, consult with lender or an attorney before commencing wor - r recording our Notice of Commencement. t-- Siinatile o Own r Le ee/Contractor as Agent for Ow el`. gnature of Contractor/License Holder STATE OF FLOR D o TATE OF FLORIDA COUNTY OF ME OUNTY OF -0U . 2 37� The forgoing ins ent was acknowledge before me o v he forgoing instrument was acknowledged before me this day of 20by 4 w o' is day of 20_ by az C�T (Name of pers,6n acknowledging) ame of person acknowledging) (Signature of Nota r ublic-State of Florida) (Signature of Notary Public-State of Florida) Personally wn OR Produced Identification Personally Known OR Produced Identification Type of Identifi tion / Type of Identification Produced / Produced Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.