HomeMy WebLinkAboutApplication for Replacement of Windows, Skylights & DoorsDATE: 11 IQA 1Q, RECEIPT: PERMITNUMBER. o'ZflZ-•d�3
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 Virginia Avenue
Fort Pierce, FL 34982
(772) 462-1553
APPLICATION FOR REPLACEMENT OF
WINDOWS, SKYLIGHTS, SWING DOORS, SLIDING GLASS DOORS
& OVERHEAD GARAGE DOORS
1. LOCATION/SITE ADDRESS: ZO C S a n e e.
2. PARCEL ID NUMBER: 'J q OD - 6 O l ' d C' 7 �� 0
3. DESCRIPTION OF PROJECT O W WORK ACTIVITY: (a GI /lC/
S� z _.4 r S; z,� . rliXi S-I nd t2 I u M, A .0 VIVI ,�a �,(s _
4. TYPE. OF: STRUCTURE: SFR V `-MOBII
5. OWNERS INFORMATION
Name: V O irOT k `moors
Address: (� 1 'I art e
City: � (+ T; e-CC..Q..Statte: PL-
Zip: 3!V__� 0 :?- Phone: 56 l - IOa -76 O-3
Email:
HOME OTHER
6. CONTRACTOR'S INFORMATION
FL Reg/Cert #: CP.COLl 6 X Se3
County Cert 9= L15 Li 3 ,/� r r_
Business Name--T4 Popy__ D,-L1�3}f�tC-tp00te-
Phone Number:
Email:
COMPONENT ID.
PRODUCT DESIGN PRESSURE
PRODUCT APPROVAL #
WINDOWS
O
(o
SKYLIGHTS
SLIDING GLASS DOOR
SWING DOOR
MULLIONS
— j06
OVERHEAD GARAGE DOOR
[] Attach 2 copies of the Product Approval with details to the product being used.
VALUE OF CONSTRUCTION: $
56 6 9 FEES DUE:
OWNER'S AFFIDAVIT: I certify that all of the information contained in this application is correct and that all work will be done in
compliance with all applicable laws regulating construction and zoning.
beg q Sie— PQ r►t i
c1
PRINT OWNER OR CONTRACTOR/QUU^ALIFIERNAMfE SIGNATURE OF OWNER OR CONTRACTOR/QUALIFIER
STATE OF FLORIDA, COUNTY OF 7Cat or -
ACKNOWLEDGED BEFORE ME THIS DAY OF 0(,20 )I , BY P)1> N S� d►'ID�C�
O P RSONALLY KNOWN TO ME R WHO HAS PRODUCED `f ,p�/�� AS IDENTIFICATION.
14 G T E F NO AR TI'PE OR RIIN NAME OF NOTARY SEAL
TITLE: NOTARY PUBLIC COMMISSION NUMBER A5� 011 15 7 D_
NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY 'RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING
YOUR NOTICE OF COMMENCEMENT.
*6101w
AMBER FLENKER
NOTARY PUBLIC
STATE OF FLORIDA
Comm# EE215692
Expires 7/11/2016