HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED -1
Date: ` aPermit Number:
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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
PROPOSED IMPROVEMENT LOCATION:
Address: '5015 Su p5fle f C 14L
Legal Description: w►►-jo 5 �5
Property Tax ID#: 131 Z 50 Z C31 -;t(3 L)OO 4 Lot No. Li 20
Site Plan Name: 0AAp51_" Block No.
Project Name: ►3A pSLf`/
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
REPLACE D WINDOWS & I DOORS WITH IMPACT. SIZE FOR SIZE.
CONSTRUCTION INFORMATION:
Additional work toe performed under this permit-check a appy:
HVAC 11 Gas Tank F]Gas Piping _Shutters Q Windows/Doors
❑Electric ❑ Plumbing Sprinklers 11 Generator E] Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ 51015 UtilitiestSewer Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name J-41- Name:Name: WAYNETHOMASBURNETT
Address: 5635 SU Nik(LW1 C 112 Company: FLORIDA HOME IMPROVEMENT ASSOC.
City: -oQY ?Iefze E State:F� Address: 3044 SW 42ND STREET
Zip Code: 34'1151 Fax: City: HOLLYWOOD State:FL
Phone No. :il-�2 4ti 1,,2% 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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 Comm enceme t.
Z��z A� Len-� — � (IM;7 s
nature of Owner/Lessee/Contra cto gent for Owner Si atur a r/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 5RtNr I-ue f f COUNTY OF Ss►1NT (,U41r
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 235 day of NOVE rM�z 20 Irby this_day of 20 _by
h
t3a,'C(.Tle'�
e- WAYNE THOMAS BURNETT
ame of p ledging) (Name of person acknowledging)
�f
(Signature of Notary Public-State of Florida) (Signa re ofotary Public-S to of Florida)
Personally Known OR Produced Identification Personally Kno n OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. &P 2C Notary F",SRtste of Florlda Commission No. (Seal)
Francisco M Almelda
c My Commission GG 139459JANETTE L LUNN
MY COMMISSION#GG032995
Revised 07/15/2014
EXPIRES August 07,2020
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS