HomeMy WebLinkAboutBuilding Permit Application (2) 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:
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FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: City:
ZIip: Phone: Zip: Phone:
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I certify that no work or installation has commenced prior to the issuance of a permit.
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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"covenant's that"may restrict or prbhibit'such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
.n 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,
ai cessory 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
6 OmmencWg work or recording our Notice of Comm en e
s
Signature of Owner ee/Contractor as Agent for Owner Siat o ra for/License Holder
STATE OF FLORIDA STA F FLORIDA
COUNTY OF 5'AIt1T COUNTY OF
The forgoing instrument was acknowledged before me The for ing ins ment was cknowledg efore me
this ay of pPP-1L 20 j8 by this day o 20 by
1 C WAYNE THOMAS SURNETT
(Name of person U (Name of person ackn edging
signature of Notary Public-State of Florida) (Signatur of Notary Public-State of Florida)
Personally Known OR Produced Identification Perso ally Known OR Produced Identification
Type of Identification Produced Type f Identification Produced
Commission No. oY'Le` Notarypp�pp State of Florida Commission No. : : MIGURI)UIERCADO
Francik�� Almeida 'c MY COMMISSION#GG095745
N' My Commission GG 139459 ;N,. r
Expire 08/2912021 ' EXPIRES April IQ_9n9i
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
;Date: Permit Number:
805 -no
Building Permit Application
Planning and Development Services
;Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
IPhone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x
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PERMIT APPLICATION FOR: Window/door
PROPOSED IMPROVEMENT LOCATION:
Address: 10304 CROSBY PL PORT ST LUCIE,FL 34986
Legal Description: POD 26 AT THE RESERVE PHASE 2 CYPRESS POINT LOT 84(OR1478-783)
it
Property Tax ID#: 3327-709-0039-000-1 Lot No.84
Site Plan Name: Block No.
Project Name;
Setbacks . Front 12 Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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REPLACE 12 WINDOWS & 0 DOORS WITH IMPACT. SIZE FOR SIZE.
CONSTRUCTION INFORMATION_ :
Additional work tobe e e orme under t is permit–check all appy:
.HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric El Plumbing []Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: 2 S . Ft.of First Floor:
CII st of Construction:$ X`) _ (0 Utilities:Sewer E]Septic Building Height:
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OWN'ERAESSEE CONTRACTOR:'
Name Name: WAYNE THOMAS BURNETT
Addre Company: FLORIDA HOME IMPROVEMENT ASSOC.
City: State:FL Address: 3044 SW 42ND STREET
Zip Code: A .—F a x- : City: HOLLYWOOD - State:FL
Phone No. ' Zip Code: 33312 Fax:
El-Mail: Phone No. 954-792-4415
Fill in fee simple Title Holder on next page(if different E-Mail: PERMITS@FHAPRODUCTS.COM
t CGC#061890
from the Owner listed above) State or County License:
If i alue of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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