HomeMy WebLinkAboutBuilding Permit Application III ALL APPLICABL IST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
2711
•
Building Permit Application
Planning and Development Services
P
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
.
PROP"OSEb;'IIVIPROVEMEIT LOCA1I:dN ;` rt z _01"
Address:2 r;YL y-��, L7r Tov-4- Qv"fc F L_ 3 KaK ,S.
Legal Description: 'T�y ;L�j ACrC,S R \IC i3 64 5 3 3 3`( 9, 3 S
Y t
Property Tax ID#: '��, os- 60{ - oo` - 00 0- 7 Lot No.3 3 3N 3
Site Plan Name: Block No. B
Project Name:_K'(1W S cZ_
Setbacks Front Back: Right Side: Left Side:
t. ��� '$ �,��` � F r
gyp` TAILED QSCRIP�TI1900 IyWOR r '
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�;._ a ,t r ,a•.'+ .. ...,-:... .. :;.. w,-_�_, ..c°a,.�2 tr x:n•. .•...�M• 4 ,,�^� ...3^.: - `` .#'•?r
REPLACE o WINDOWS & v DOORS WITH IMPACT. SIZE FOR SIZE.
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0, S' ' R C1I, N,IIV�FRN�ATQNA � b k
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Additional work toe e orme un er t Is permit-c ec a appy: A
HVAC E]Gas Tank ❑Gas Piping _Shutters ✓a Windows/Doors
11 Electric 0 Plumbing Sprinklers Generator 1:1Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ ��. Q 7 Utilities:cnSewer ElSeptic Building Height:
€OWNER/LESS'EE,�N<, �# ONTRACTf9R; ko
rt
�... ,u
Nam 0S C S e: WAYNETHOMAS BURNETT
Address: Company: FLORIDA HOME IMPROVEMENT ASSOC.
City: ��— State:FL Address: 3044 SW 42ND STREET
Zip Code:� -1 Fax: City: HOLLYWOOD State:FL
Phone No. 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.
Ss� PaPLEfViNTALCU�NSTRIlCT!® lllEN IAVUI� IFORNIAT!' N'
? ''V7,P7;.C'r
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: X 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 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 work or recording our Notice of Commencement.
Add�) ' W,10�2s
Signature of Owner/Lessee/Contractor as Agent for Owner 1 t o ontractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The for Ding instrument was acknowledged before me The forgoing instrume was acknowledged before me
this day ofE7crDZF,9 201'7 bythis day of 20 by
C.-Il#P—D WAYNE THOMAS BURNETT
(Name of person ack rl i g-- (Name of person acknowledging) ,;;aY;��;,, JAN]ETTE E L N
My COMMISSION# 032995.
�T�4°flt°ar EXPIRES August 0, 2020 }
(Signature of Notary Public-State of Florida) (Signa re of Notary P lic-State o
Personally Known OR Produced identification Personally Known OR Produced Identification
Type of Identification c „ A Type of Identification Produced
Notary P��glIic late at Florida
Commission No. rFrancisdo�Pnl3kl Commission No. (Seal)
imeida
My commission GG 139459
y?f� P Expires 08/29/2021
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS