HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: Permit Number: 1 V V I/ ,' •
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COUNTY ' ,�C "
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Building Permit Application JUN
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Planning and Development Servicesittln9 De
Building and Code Regulation Division St; c/e County
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Window/door
PROPOSED IMPROVEMENT LOCATION:
Address: 9331 AVENEL LN
Legal Description: PAINESATTHE RESERVE Wv\A
Property Tax ID#: 3322-502-0020-000-5 Lot No.14
Site Plan Name: JOHN SANTACROCE Block No.
Project Name: JOHN SANTACROCE
Setbacks Front - Back: 3 Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
REPLACE 2 WINDOWS & 1 DOORS WITH IMPACT. SIZE FOR SIZE.
CONSTRUCTION INFORMATION:
• Additional work to be erformed under this permit—check all- apply:
HVACI I Gas Tank nGas Piping _Shutters ✓Q Windows/Doors
- ;O Electric 0Plumbing O Sprinklers El Generator 0 Roof Roof pitch
f.. :,Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$_k,3 I CO CO Utilities: Sewer El Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name JOHN SANTACROE Name: WAYNE THOMAS BURNETT
Address:9331 AVENL LN Company: FLORIDA HOME IMPROVEMENT ASSOC.
City: PORT ST LUCIE State:FL Address: 3044 SW 42ND STREET
Zip Code: 34986 Fax: City: HOLLYWOOD State:FL
Phone No. '1.—a' \ — 4,kkk!, Zip Code: 33312 Fax:
E-Mail: Phone No. 954-7924415
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: _Not Applicable
Name: Name:WAYNE THOMAS BURNETT
Address: Address:
City: State: City: HOLLYWOOD State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Add reSS:3044 SW42ND ST Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 contlict 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 Commence
tP/$0,;:„.„-e--
Signafre of Ownevieee/Contractor as Agent for Owner Si_ . yi -.4v,� actor/License Holder
STATE OF FLORIDA TA )>' RIDA
COUNTY OF 54."I- (1v'6Mt C , N OF
The forgoing instrument was acknowledged before me The fo oing instrument was acknowledgjee l before me
this 30 day of 5— ,20 aS by this 11 day of ./ 4/e ,20r by
•I%vt ‘ins!a coat(
Name of persyo�making statement Name of p son making statement
Personally Known V OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signat - . • . . -• - : - : : :. (Si:
„�""6•- MATTHEW SIRKINS ,,w��
Cornmiss3gn��+'.: = MY COMMISSION#GG11(§ ) . ission o. �'c MY COMMISSION# 45
' �� EXPIRES April 19,2021
or i��' EXPIRES July 02,2021 '.�
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17