HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED p /►,
Date: Permit Number:MIN
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Building Permit Applicatio i
Planning and Development Services MAR 2 6 2018
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 Permitting D e p a rtr
Phone: (772)462-1553 Fax: (772)462-1578 Commercial er'itl�LY,
PERMIT APPLICATION FOR: Window/door
PROPOSED (IMPROVEMENT LOCATION:
Address: 2% Q N E A Qh j rl S a + I A V Q
Legal Description: R, ✓2( f od k V1NT '�- 1 QC tC (Wzk 80 L01-0(
PropertyTaxlD#: 3111,1` Lot No.
Site Plan Name:J4f+f %\Af ma( t7if\ Block No. 4?0
Project Name:- -O A( mu,J� h �
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
=REPLACEWINDOWS & DOORS WITH IMPACT. SIZE FOR SIZE.
CONSTRUCTION INFORMATION:
Additional work toa er orme under this permit—check a appy:
HVAC Ei Gas Tank Gas Piping Shutters /
_ ✓ Doors
11 Q Windows
Electric ❑Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ Utilities:0Sewer DSeptic Building Height:
OWN ERAESSE'E: CONTRACTOR:,`
Name 1.t1�� Name: wAYNETHOMASBURNETT
Addr �,. Company: FLORIDA HOME IMPROVEMENT ASSOC.
City:C!:� State:FL Address: 3044 SW 42ND STREET
Zip Code: Fax: City: HOLLYWOOD State:FL
Phone No. Zip Code: 33312 Fax:
E-Mail: t 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 Commencement.
s
Signature of Owner/Les ee/Contractor as Agent for Owner Si u C ntractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SAINIV l,uc,f__ COUNTY OF
The forgoing instrument was acknowledged before me The fo oing instrument was acknowledged 'a-fore me
this 134, day of nPe 20 _by this day of 20 e ?j by
AR;FIA �,4 ` IV WAYNE THOMAS BURNET
(Name of per ackno g) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signatur o ary
Public- to of Florida )
Personally Known OR Produced Identification Persona own roduced Identification
Type of Identification Produced Type of Identification Produced
Commission No. Pr, ommission No.
rf&®�I public state®I!?ie�i��
Francisc9 M AfRioldS 4►"'".� MIGUEL A MERCADO
c Gey Ca a+n;+as 00 15�As9 ::'-
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211
Revised 07/15/2014 `? � VN..
EXPIRES EXPIRES April 19,2021
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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