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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �^�//�� /�
Permit Number: lis oa - 691(/
0 1
Date:
•
Building Permit Application RECEIVED
Planning and Development Services FEB 12 2018
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 Permitting Department
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x St. Lucie countv
PERMIT APPLICATION FOR: Window/door
PROPOSED IMPROVEMENT LOCATION:
Address: 'b CL :-Q-"A �Y��r ya 'l; ' S-7
Legal Description: V�6\V6:1\-k b:t WC 'Q4. Lllxl_-e� C_ lb -T 31 MC) !S [�l�c, �•ci�
Property Tax ID #: A5 it _ e_7t i G'ZA t — f.C� C Lot No.
Site Plan Name: Block No. (-X'
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
REPLACE i 5 WINDOWS & J DOORS WITH IMPACT. SIZE FOR SIZE.
CONSTRUCTION INFORMATION:
Additionalworkto e er orme under t is permit — check a appy:
HVAC Gas Tank ❑Gas Piping _ Shutters Q Windows/Doors
11 Electric 0 Plumbing U Sprinklers ❑ Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $�'�
Sq. Ft. of First Floor: _
Utilities: Sewer 11 Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
/� n
Name ` Re -I'd
Name: WAYNE THOMAS BURNETT
Address: — 3,
Company: FLORIDA HOME IMPROVEMENT ASSOC.
City: .r C State: FL
Zip Code: w Fax:
Phone No. ��ji — ?�r�— d0 g
Address: 3044 SW 42ND STREET
City: HOLLYWOOD State: FL
Zip Code: 33312 Fax:
Phone No. 954-792-4415
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: PERMITS@FHAPRODUCTS.COM
State or County License: CGC#061890
If value of construction is 52500 or more, a KtCUKutD Notice OT commencement is requires.
RECEIVED
FEB 12 2018
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
Permitting Bev
St. Lucie county
DESIGNER/ENGINEER: X Not Applicable
Name:
MORTGAGE COMPANY:
Name:
X Not Applicable
Address:
Address:
MANGROVE
City: State:
Zip: Phone:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
BONDING COMPANY:
Name:
X Not Applicable
Address:
Address:
DATE
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 thepermit 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 your Notice of Commencement.
vic2l --K& Ili, AIAJ Cele' L., " E�- c.,- s
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF S+ LVGE .
The forgoing instrument was acknowledged before me
this day of J A.aJA4?1 , 20 l$ by
(Name of person
(Signature of Notary Public- State of Florida )
Personally Known _
Type of Identification P
Commission No.
Revised 07/15/2014
OR Produced Identification
STATE OF FLORIDA
COUNTY OF . W x C..
The forgoing instrument was acknowledged before me
this_pk_ day of ) 20 1 by
WAYNE THOMAS BURNETT
(Name of person acknowledging )
(Signaturer Notary Publi - Staie of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
NotmpacI is State of Florida I�Commission No.
Francisr M Almeida ICK
My Commission GG 139459
(Seal)
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
Floode Home Improvement Aaaoclates
License No. CQC 06169010644111
1044 SW 42nd Si, FI Lauderdale. F L 13112
,)obtllf /!5A29G 61
Name:
Arld—
FLOe1DA
HOMe
iMPROVCMCNT
AasOclATfs
F Replacement Windows
SIJ Hon Phone:
dl 7D . �TAU.s�
day of ��f/��20�(I b
bov of the
Broward Tal: 954792.4415
Miami Dade Tel: 305.545-4469
Fax: 954-792-2170
Web: FHAPRODUCTS.COM
Email: INFOOFHAP/RODUCTS.COM
Bus. Phhoon(io (�/L�joo :%iz—
(
' State Zip
This Contract is mark and entered into this
y and between Florida Home -Improvement Associates, Inc,
a Florida corporation ("Contractor^ or 'FHA'), and owner(s) named a residence
located at the address listed above ("owner`).
7M Work Contractor agrees to perform the work described below:
Directions are viewed From the Inside.
1) Remove existing units to be replaced. (NOTE: Removed items are likely to be
damaged.)
On sliding Glass door% Active and fixed
2) Prepare openin s as ttssary to receive replacement units.
Panels are Id.."fl d. on Cid rri
French doom the hinge is
3) N9NDOWS: FHA Energy Stone Saver _ Simonton Vinyl Insulated
and singk
IdentHkd Right Hinge and left Hinge.
Install Aluminum Insulated, Aluminum Non -Insulated
on Double -French Doors the more
__
j
active door Is ides~
4) 000rs:_ FMA Energy Storm Saver _ Aluminum Insulated, Aluminum Non -Insulated
imrtelrt. ! Nen-lmmrtr f 1 Celer: White Tan:
Bronze: Grey: MIII Finish:
fj Double Nuna Slnak "Una
Yes( 1 No(
Standard_ Qty cm -6 4tY
Custom
JZACM Fo FA AF
Grimm A
caiemen p
0h
a RH ( 0
L.—"
Q
Qty
swino Gloss Door S male French Doors
AA AF FA FAAF AAF FAA RH( ) )
Qty_ QTY I QtyQty— Qty_ QtY— Qty
Doubk French Door met
RAI I )
Qty
Glass: 1 /G 044 - INITIAL HERE 41,60
Warranty: r Manufacturer's Warranty sent upon cc000mp�eetiittiioon.
5) Work NOT to be replaced: �{LOZ ��� INITIAL HERE:3"
6) ff appilcable, removing shutter panels, and/or security bars. / INI l IAL MMM --mar
7) Specitl Instructpns: // ![;0 — ���✓�e��Il
8) Cleanup Job debris and provide necessity, permits and insurance.
9) if applicable, In the event that Contractor is unable for whatever reason to obtain proper permits prior to commencement of any work,
Contractor shall refund any previous payment and this transaction shall be automatically cancelled.
(No finish work o r than normal installation is to be done unless noted below.)
Additional Work: /!4 �-rz,
Schedule: Contractor steal Commence a work within all after execution of the Contract (the "Commencement Date`) and shall endeavor to
complete all Work hereunder within ays after the Commencement Date. 'rn9� rContract Price >
A011- ' �% & Sales Tax ( %) $—" � j
The TOTAL PRICE for all Labor and Materials (including any applicable discount) is $ v (if applicable) ? -�Oo
Down Payment $
Balance Payable $ Total Contract Price
Contractor will provide to Owner a Final Waiver and Release of Lien and Contractor's Fin Affidavit to Owner, substantially similar to the forms
icludod In rhaoter 713. Find to ues 12013SI.
Grcle one: (yrs N0J ner erects to applyfor f nancing of the above -statue lump sum amount. if yes is circled, see financing agreement
and related doe
Notke m the ownw, M Powtdng b baba obtaied by owner:
a). Do not sign tsaa heew Irnprowment contract (including financing documents) In blank.
le). You are antlttad to a copy of the contract at the time you sign. Keep it to project your legal rights.
c). The financial dOCaelants attached to this home Improvement contract may contain a mortgage or otherwise create a lien on your property that could be foreclosed
on a you de net pi s* sure you undamLnd NI provisions of the contract and Rnanciai documents before you sign.
Mimliamil This contract contains the entire contract of the parties. it may not be changed orally but only by a signed change order or othe,
written amendment. The waiver by any party of a breach of any provision Of this contract shall not operate or be construed as a waiver of a--
subsequent breach by any party.
N WITNESS WHEREOF, the Parties hereto have executed this contract, under seal, as of the day and year first above written
You the Buyer may cancel this transaction at any time prior to midnight on the third business day after the date of this transaction.
See the attacw notice of
cancellation form } n explanation of this right.
Ow er. di/� i Co4(Name�
By:
(Signature of Owner)
(Signature of Owner; Date
Home Owffers Association Nome: iDR1/ Phones: 2uI 2926
IDES (� NO ( ) Building Name:
RECEIVED
FEB 1 2 1.018
Permitting Department -
St. Lucie Counts
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