HomeMy WebLinkAboutz ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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/ OL(-25eDate: Permit Number: (p
COUNTY Q�q�„
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welmempp Building Permit Application Jay i
Planning and Development Services Perms i gZoe®
Building and Code Regulation Division St LQ-2 Depa
2300 Virginia Avenue,Fort Pierce FL 34982 HQ Coyntment
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X y
PERMIT APPLICATION FOR: Window/door
PROPOSED IMPROVEMENT,LOCATION:
Address:'LICA k., Coco nuk PN e. Vos\- S\ Lv�� e ; i= L, 3<--1 CAS"Z_
Legal Description: �°\/P C Vc I\L U'rl;A-7
Property Tax ID#: 34\CA- 510-0 i 2.q-ooc- \ Lot No. 1 `
Site Plan Name: \iCaiC\ r -ci Block No. 1Ct
Project Name: (.Nr\. c__";c\ 'SThoC1\�..(
Setbacks Front_ 2 Back: 3 Right Side: Left Side: 1
DETAILED DESCRIPTION OF WORK:
REPLACE -3 WINDOWS & "3 DOORS WITH IMPACT. SIZE FOR SIZE.
CONSTRUCTION INFORMATION:
Additional work to be ortormed under this permit-check all apply:
❑HVAC _Gas Tank Gas Piping Shutters 1/ Windows/Doors
0Electric 0 Plumbing Sprinklers _Generator _Roof Roof pitch
Total Sq. Ft of Construction: sol. Ft. of First Floor:n
Cost of Construction:$ 70 1LkZ\ Utilities: Sewer I (Septic Building Height:
OWNER/LESSEE:. -: ' . CONTRACTOR:..
Name Alicia A Donley Name: WAYNE THOMAS BURNETT
Address:404 E Coconut AVE Company: FLORIDA HOME IMPROVEMENT ASSOC.
City: Port St Lucie State:FL Address: 3044 SW 42ND STREET
Zip Code: 34952 Fax: City: HOLLYWOOD State:FL
Phone No.772-607-2368 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$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONST UCTION LIE`I LAYS/ iNF-ORMATION k1, -- £$ # ,--r `,
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: r
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 your Notice of Commencem-
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Signature of Owner/Lessee/Contractor as Agent for Owner Si ! X1:1ractor/License Holder
STATE OF FLORIDA STA a F FLORIDA
COUNTY OF COUNTY OF ac \A_VA .
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
6.44%this + day ofi .3E— , 20 I15by this day of J J%.6 ,20 Vt., by
A\`1(S O DO ' 1 WAYNE THOMAS BURNETr
(Name of perso• . .•..a• g) (Name of person .ckri dging)
40
(Signature of Notary Public- tate of Florida) (S.:nature . Notary !.�.I• .te of Florida)
Personally Known I OR Produced Identification Person. y Knu, OR Produced Identification
Type of Identification Produ -• pe .if Id-- i cation Produce.
Y v Notary Public State of Florida tib:?iii IMIMI v
Commission No. a. `f; If. ASco M Almeida �.m• ion No. =_°'. am . , y GOMM1 #GG0951
p My Commission GG 139459 .y �: EXPIRES April 19,2021
`' '°crc%.c,gc Expires 08/29/2021 ?aF,1,
•
Revised 07/15/2014 /
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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DATE
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INITIALS