HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 13� �{ Permit Number:,$6-1"dd91
RECEIVED
Building Permit Application JUL 03
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Window/door
PROPOSED IMPROVEMENT LOCATION;-
Address: ( VI 1 1'L \
Legal Description: \D0-y-) 2(o N V- -e 3e.se(\/e -PhC c _ i l Cvh�eSS � I r1
Property Tax ID#: 750;Q— _7 — 6()()—q Lot No. I(A
Site Plan Name: u<o V-1cv Block No.
Project Name: OnCAI
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK.
REPLACE WINDOWS & DOORS WITH IMPACT. SIZE FOR SIZE.
CONSTRUCTION'INFORMATION:
Additional work to be nerformed under t ispermit—c ec a ,t at appy:
L�HVAC Gas Tank Gas Piping _Shutters Q Windows/Doors
Electric Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
//
Cost of Construction:$ (O Utilities:[]Sewer Septic Building Height:
r..
OWNER/LESSEE: CONTRACTOR:
Name James T Leonard &Maredith Leonard Name: WAYNE THOMAS BURNETT
Address:10101 Crosby PI 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.772-260-2206 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$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will,in all respects, perform the work
in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commenc men
)�4� 012� � ml�pr S
Signature of Owner/Lessee/Contractor as Agent for Owner Si n toor/License Holder
STATE OF FLORIDA ST T F FLORIDA
COUNTY OF CO OF
The forgoing instrument was acknowledged before me The f rgoing instrument was acknowledged re me
this i3 %day of .10"F— 20 I$by thi�day of 20 My by
WAYNE THOMAS BURNETT
(Name of perso no ) (Name of person acknowledging)
(Signature of Notary P lic-State of Florida) (Signature Nota ublic-State of Florida)
Personally Known OR Produced Identification Perso Ily K n OR Produced Identification
Type of Identification Prod ype fl ification Produced
,s0Pag` Notary Public State of Florida iMi�llEl CAD®
Commission No. ? Fr(g $Po M Almeida o ssion No. :'s?"'°�c- �( Fa
q� ; �R My Commission GG 139459 ;• MY COMMISSION##�GG0957 55
raQffl�a Expires 08/2912021
;�,•... EXPIRES April 19,2021
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
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