HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Rermit Number:
Building Permit Ap lication SF<G�9oP �oiB
Planning and Development Services Pco�a't5�
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 IMPROVEMENT LOCATION:
Address: 8004 FORT WALTON AVE �
Legal Description: LAKEWOOD PARK UNIT 6
Property Tax ID#: 1301-606-0110-000-1 Lot No.2
Site Plan Name: SUSAN GARMAN Block No. 63
Project Name: SUSAN GARMAN
Setbacks Front 3 Back: Right Side: 1 Left Side:
[DETAILED DESCRIPTION OF WORK:
REPLACE 4 WINDOWS & 0 DOORS WITH IMP CT. SIZE FOR SIZE.
CONSTRUCTION INFORMATION:
Additional work toe e orme under this permit—check a y:
HVAC E]Gas Tank Gas Piping pp_ hutters Windows/Doors
Electric 0 Plumbing Sprinklers enerator Roof Roof pitch
Total.Sq. Ft of Construction: S Ft.o First Floor:
Cost of Construction:$`r Utilities:qn S wer 0 Septic Building Height:
OWNER/LESSEE: CONT CTOR:
Name SUSAN GARMAN Nam,. WAYNE THOMAS BURNETT
Address:8004 FORT WALTON AVE Compa y: FLORIDA HOME IMPROVEMENT ASSOC.
City: FORT PIERCE state:FL Addres : 3044 SW 42ND STREET
Zip Code: 34951 Fax: City: H LLYWOOD State:FL
Phone No.�n�" a%1a - Lp\ ko Zip Co e: 33312 Fax:
E-Mail: Phone o. 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 CONSTRUCTI01� LIED LAIN 11ORMATI >U� `
DESIGN ER/ENGINEER: x Not Applicable MORTGA E COMPANY: _Not Applicable
Name: V-)e ktn Q1Q- nCn Nape:WA NETHOMASBURNETT
Address: f� U1 :T-C �iJ6k c�� IA��-� Address:
City: C�k pi 410,0 State: City: HOLL WOOD State:
Zip: <- Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDIN COMPANY: Not Applicable
Name: Name:
Address:3044 SW 42ND ST Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT:Application is hereby made to obtai 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 authori a 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. Luci 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 z ccessory 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 mut be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, cons Lilt with lender or an attorney before
commencing work or recording our Notice of Commencement.
-P.&Ltol Ix
Signature of Owner/Lessee/Contractor as Agent for Owner S a u o tractor/License Holder
STATE OF FLORIDA S T FLORIDA
COUNTY OF lJ'wv. � (' COUNT OF
The forgoing instrument was acknowledged before me The f rgoi g instrui ent watacknowledge before me
this T day of � 20 /$by this ay of 20 4 by
Name of person making statement amp of person/ming statement
Personally Known OR Produced Identification Personal) Known � Produced Identification
-Type of Identification — -Type of Id-ratification -
Produced Produced _
5i na o ar
(Signa urq%of.d�otarpA%ftR�t�kRflgAa) ( g al
-
a, `•a L A MERCADO
'' "• MY COMMISSION#GG11 8
Comm ` ' �"� e 1 � Co `= MY COMMISSION#GG0957 al)
2.2021 EXPIRES April 19,2021
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE '
RECEIVED _ I
DATE
COMPLETED L
Rev. 8/2/17