HomeMy WebLinkAboutBuilding Permit Application (2) ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
•
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 INIPROUElM NT L' ATIQN
-`
Address: (01Z� ��kMe7(lUa —C� '\U Q-I 'P%,, �3WCV 1
Legal Description: -, 1. ykON4s I&ISO Ljok 2)
"�u
Property Tax lD#: Q��_ 5M _6"Ok- Cccr3 Lot No.
Site Plan Name: n_ Block No.
Project Name: _wcx�d 0 am%a Dl
Setbacks Front 2 Back: Right Side: Left Side:
`DETAILED'DESCRIPTION OF 1NORK:
REPLACE WINDOWS & DOORS WITH IMPACT. SIZE FOR SIZE.
CONSTR,UCTfON IN;FOR,MATION ;
Additional work to be performed un ert is permit c erk a appy:
HVAC Gas Tank FGas Piping Shutters ✓Q Windows/Doors
Electric 0 Plumbing Sprinklers [:]Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
;Cost of Construction:$ Q Utilities:0Sewer Septic Building Height:
-OWNER/LESSEE CQ'NTRACTOR
_.
'Name l G Name: WAYNE THOMAS BURNETT
Address�:T s� T Company: FLORIDA HOME IMPROVEMENT ASSOC.
City: rV[c` t�\e�� State:F� Address: 3044 SW 42ND STREET
Zip Code: Fax:
City: HOLLYWOOD State:FL
Phone No. (O (� 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: _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 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
iln 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 Commenc
s
Signature of Own e r/LessTe/C96tractor as Agent for Owner Sigt eUn&RIDA to License Holder
E OF FLORIDA STAT
COUNTY OF 5AIWI %A>c.aE COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrum nt was acknowledged efore me
this IBN+day of APWL 20 &by this__,,kday of 20 by
� �` / �� , WAYNE THOMAS BURNETT
A Y"- A
;(Name of person (Name of person acknowledging)
A--
(Signature of Notary Public-State of Florida) (Signature o otary P'Dbffc-St a a of Florida)
'Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
(Commission No. Notary Pl(�ea Late of Florida Commission No. (Seal)
r° `� Francisco M Almeida JANETTE L LUNN
I _ My Commission GG 13945 q�=
'•oFf•°Q X 11 MI SION*GG032995
Revised 07/15/20 ''�{ EXPIRES August 07,2020
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
'DATE
COMPLETE
INITIALS