HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFOMUSTBE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �Z, ' "I Permit Number:
RECEIVED
1
Building Permit Applicatio FEBEE1 20
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 LOCATIONS
Address: 10 10 1 (`rosb y L ti G.�N �--u 6 Z COU q g G
Legal Description: Qbg ),G Ptd SHF. {1r✓sE6ZyE Pl�/kSC- -LL ,ss �0�>\1� �..yfi log (0 a18_7--x(07,
Property Tax ID#: 3 Nil- 70 q_ 60 TA - B co-9 Lot No. tog
Site Plan Name: t E C N AUIS kES l pe N Ce Block No.
Project Name: �ZO wqa. Is Qc-5iD wise
Setbacks Front Back: Right Side: Left Side:
r
DETAILED DESCRIPTION:O'F,UVO'RK
REPLACE J' WINDOWS & DOORS WITH IMPACT. SIZE FOR SIZE.
CONSTRUCTIO:N:INfORMATION:
Additional work to be performed under this permit—check a appy:
HVAC Gas Tank ❑Gas PipingOGenerator
Shutters Q Windows/Doors
11 Electric El Plumbing ❑Sprinklers Roof Roof pitch
Total Sq. Ft of Construction: �nO 5Q �T S . Ft.of First Floor:
Cost of Construction:$ 1 i CJ 6`l• (30 Utilities: _Sewer E]Septic Building Height:
OWNER/LESSEE. CONTRACTOR:
Name Mo r2dl4k d-Q_ouc(1-d Name: WAYNETHOMASBURNETT
Address:'110161 i �,roA4 PL. Company: FLORIDA HOME IMPROVEMENT ASSOC.
City: �of t� SAA�(LU04, - State:FL Address: 3044 SW 42ND STREET
Zip Code: `1D Fax: City: HOLLYWOOD State:FL
Phone No. �7�' dv ' 3�-CJ`( , 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 Commencem nt must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain fins co ult with lender or an attorney before
commencingwork or recordingour Notice of Comme c t.
s
Signature of Owner/Lessee/Contractor as Agent for Owner 51 n ture of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 5At wr wc. a COUNTY OF �7 Z
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thisZWday of .5ANO&T.7 . 20 M by this day of ���'� 20 14' by
y &�r&64 LLQ WAYNETHOMASBURNM
(Name of person le n (Na7fpacknowledging)
(Signature of 146tary Public-State of Florida) (Signature tary Public-State of Florida)
Personally Known OR Produced Identification Per n y Known `-�" OR Produced Identification
Type of Identification Pr c ,tee„ ��, � ✓ of Identification Produced
�,gY ru Notary Public State of Florida
Commission No. a°A �^ Francies@$Il►Almeida Commission No. :��"•�''�8�; MIGUEL.A I(tR*ADO
ae My commis_si66n GG 139459 _
y Expires 08/29/2021 MY COMMISSION#GG095745
``GF rM1� -�y. .@�:
EXPIRES April 19,2021
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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