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HomeMy WebLinkAboutBuilding Permit Application ' r ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /916 /^_0 n� Date: //]��` Permit Number: / ftECE VIVI ED ._, s - :- - Building Permit Application JUL 2 7 2018 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 1 M'P-ROVEMENT°LO_CATION Address:TW5 [�Ara,-AOIC 2::&W�O glve\ Legal Description: T-O( - �>%e rce- �1ru���S lJJ�1L Property Tax ID#:Iy3b-�0 1 -QD&,1-0onI 7 Lot No. o� �3 Site Plan Name:-�:(C_\,)(nsTBlock No. 7J Project Name: T-'Y a i2e�S Ph C1 na mDa r Q Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK REPLACE WINDOWS & SIZE FOR SIZE. FL.1 k6_� 36 ?1-D, rL���© - � [(:b:N:STR,UCTION,INFORMATION; Additional work to be nertormed under this permit—check all that appy: HVAC Gas Tank Gas Piping El Shutters Q Windows/Doors Electric 0 Plumbing []Sprinklers 11 Generator Roof Roof pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction: $ I I90D Utilities: Sewer Septic Building Height: OWNER/LESSEE CONTRACTOR:. Namela-A nc'S �A 1 f 'Y OnU-O-,etc Name: WAYNE THOMAS BURNETT Address:�ZCI 7� `f-rt�Gn �C` ` 'h � ��e-�_ Company: FLORIDA HOME IMPROVEMENT ASSOC. City:V ay O uc-e State:FL Address: 3044 SW 42ND STREET Zip Code: 39 9 y CI Fax: City: HOLLYWOOD State:FL Phone No.-1 IL TO 1 -9 C19 I, 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: CSC#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 thepermit 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 workor recording our Notice of Commencement. S1C•j^rr-'gl�• l" O b S Signature of Owner/Lessee/Contractor as Agent for Owner Si a ontractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 50J1+9T- LVC.tF_ COUNTY OF r The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me thisZ`✓�day of .JULY 20 ls3 by this day of 5 U1.:4 20 $ by IFC'q r-4 X Pit •V„,A V%Q4 G Fy WAYNE THOMAS BURNEfT (Name of person owl ) (Name of person acknowl (Signature of Notary Public-State of Florida) (Signat e o ary P c-State of Florida—) Personally Known_71 OR Produced Identification Person y Kri OR Produced Identification Type of Identification Produce Type f Id i ' ation Produced u,,sx Notary public State of Florida Commission No. ° r, Fra I&AW)v1 Almeida C i on No. o, "'°©', MIGUEL P(MrIWCADO Q My Commission GG 139459 - MY COMMISSION#GG095745 �+ o Expires 0812912021 Y� PQc r-XRIPr- April 10 9091 Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS