HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE NFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED=County,
Date:1 Permit NumBuilding Permit Applicatio
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 FOWindow/ or
PROPOSED IMPROVEMENT LOCATION:
Address: 6307 Lilvan PKWY Fort Pierce,FL 34951
Legal Description. LAKEWOOD PARK-UNIT 8-A-BLK 5 LOT 28(MAP 13/02S) (OR 3741-236)
Property Tax ID#: 1301-609-0072-000-1 Lot No.
Site Plan Name: Block No.
Project Name: Cynthia S Cook
Setbacks Front Back: Right Side: Left Side:
DETAILED.D.ESCRIPTION OF WORK:
Replace 6 Windows W/Impact. Size for size.
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit—cleck all appy:
HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
0 Electric 0 Plumbing Sprinklers Generator g Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 7,450 Utilities: Sewer Septic Building Height:
OWN ERAESSEE: CONTRACTOR:
Name Cynthia S Cook Name: BURNETT WAYNE
Address:6307 Lilyan PKWY Company: FLORIDA HOME IMPROVEMENT ASSOC
City: Fort Pierce State:FL Address: 3044 SW 42 ST
Zip Code: 34951 Fax: City: HOLLYWOOD State:FI
Phone No, Zip Code: 33312 Fax: 407-4728380
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: FI
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
,., -- - - _
-SUPPLEMENTAL CON t!G'ON �DEI89
LAW,ITR ;!4TI� :
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: ®,Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDEN: �Not Applicable BONDING COMPANY., Not Applicable
Name: Name:
Address: 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 conflict with any applicable Home Oumers 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,walis,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
C,-,t& , 6-,�J" , - �(� RW
S-nature of Owner/Lessee/Contractor as Agent for Owner f ctor/License Holder
NATE OF FLORID STATE OF FLORIDA
COUN'T'Y OF ��. �,cc [ COUNTY OF .57;L OL i e-
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this�day of .., ,20� by this LS day of �,, _ .20- by
Name of person making statement kJame of pars n making statement
Personally Known X_OR Produced identification Personally Known OR Produced Identification
Type of identification Type of identification
Produced ."N Produced
ArA
lsi Notary Public-State of \��S at f Notary Public State of 1`1
ommission No. r vue�, ' qtr g 0
a - m\ c�aq Commission No.
z og �
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rear.8/2/17