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ALL APPLICABLEINFOMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED rr�
Date: ('� 2.�D Permit Number: LJ I ® (JO 1
RECEIVED
Building Permit Application OCT 26 2018
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR:. Window/door
PROPOSED'IM'PROVEMENT LOCATION:,
Address: 5715 Sunset BLVD Fort Pierce,FL 34982
Legal Description. INDIAN RIVER ESTATES-UNIT 08-BLK 64 LOTS 10 AND 30 (MAP 34/11 N)
Property Tax ID#: 3402-609-0448-000-4 Lot No.10 AND 30
Site Plan Name: Block No.
Project Name: Dennis Gore ;Judy H Peters
Setbacks Front Back: Right Side: Left Side:
DETAILED' DESCRIPTION-OF WORK:
Replace 1 Windows and 1 Door W/Impact, Size for size.
I 'CbNSTRUCTI'ON 'INFORIV(ATI'ON-.---------
Additional
work to be nertormed under tis permit—check a appy:
HVAC Gas Tank E]Gas Piping Shutters Windows/Doors
Electric Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
e ,,Cost of Construction:$ 5,580 Utilities,
Septic Building Height:
OWNERAESSEE: 'XCONTRACTOR:
Name Dennis Gore;Judy H Peters Name: WAYNE T.BURNETT
Address:5715 Sunset BLVD Company: FLORIDA HOME IMPROVEMENT ASSOC
City: Fort Pierce, State: FL Address: 3044 SW 42 St.
Zip Code: 34982 Fax: City: HOLLYWOOD State:FL
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: FHAPRODUCTS.COM
from the Owner listed above) State or County License:
"'if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
.fid.
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SUPPLEMENTAL CONMUCTION LIEN'LAW INFORMATION'
DESIGNER/ENGINEER: _Not Applicable "MORTGAGE COMPANY: Not Applicable
Name:DenNsGorbq Judy HPeters Name:MYNET.BURNEW
Address:s is sumk= Address: 3044 s St.
City; Fort Memo, State: n City: HOLLYMOD State; F<
Zip: 8402 hd9e Zip: 33312 P One,
FEE SIMPLE TITLE HOLDER: _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 makees�no representation that Is granting apermitwill authorize the permit holder to build the subject s�vcture
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which is in conflict with any applicable Home Owers 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,l 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 Commencement
X
Signature of Owner/Lessee/Contractor as Agent for Owner Sign a tractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF _c_t 'I_S,,f A—f COUNTY OF rA L�C
{
The forgoing instrument was acknowled ed before me The forgoing instrument was acknowledged befo%pe
this I l day of G rs3– 20V by this day of GLS 20�g
Id
Name of person aking statement Name of perso aking stateme •
Personally Known�OR Produced Identification Personally Known XOR Produced Itift.01 .G
Type of Identification Type of Identification
Produced Produd
Oi�Irj ZQ ��
r f Notary Public-State ature of Notary Public-'State of Florida)
20
Commission No. � ®�F� Commission No. (Seal)
•,�\X
REVIEWSRO ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE i
C TER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17