HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: to
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: Window/door
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Address: 5507PL r3qyT2
4 6y+ Pierce
Legal Description:_TWA'zn Xiyer 14- 1 0/k, aS +L//
Property Tax ID#: 3*401002 WCn Lot No!��?
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
REV
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REPLACE 7 WINDOWS & DOORS WITH IMPACT. SIZE FOR SIZE.
AcIc0ional work to be ertormed under this permit-c ieck all that apply:
R HVAC ri Gas Tank F]Gas Piping F-Lutters Fv�Windows/Doors
nElectric 0 Plumbing ]Sprinklers Elenerator Roof Roof pitch
Total Sq. Ft of Construction: Sq.Ft.SewerF❑
of First Floor:
4 Utilities:[]
Cost of Construction:$11, 1 Septic Building Height:
_
INNER/LESSEE: wxr
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Name Fail irtl Name- WAYNE TH6MAS BURNETT
Address: .9307 Syal.n b'r Company: FLORIDA HOME IMPROVEMENT ASSOC.
City: State:FL Address: 3044 SW 42ND STREET
Zip Code: - ,qqjl_ Fax: City: HOLLYWOOD State:FL
Phone No. 77zQq-011t Zip Code: 33312 Fax:
E-Mail: Phone No. 954-792-4415
Fill in fee simple Title Holder on next page(if different E-Mail:-PERMITS,@FHAPRODUCTS.COM
from the Owner listed above) State or County License: CGC#061890
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SIJJP'PLEIVIENI"AL C®NS�TRkIJCT ON LIEN' l ASW INF®RMA ION
t, .r
DESIGNER/ENGINEER: XX Not Applicable MORTGAGE COMPANY: —Not Applicable
Name: Name:
Address: [Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I
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 cdvenants 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
com mencing work or recording our N e of Comm e e e t
t
s
Signature of-Owner/Lessee/Contractor as Agent for Owner ctor icense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instru gent was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20 a—by this_day of 20 by
2, Q
a / lb t. 1 Ay WAYNE THOMAS BURNETT
(Name of person acknowle Ing) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature f Notary Public-St to of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission N ;:�:e •. JOE PIETRAGALLO(Seal) Commission No.
:Commission#GG 080035 �""Y"` JANETTE L LU
NN
my COMMISSION C
91
O""'° e o Fai °.!f p EXPIRES August 07,2020
1•d•
Revised 07 .157,02-1
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS