HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
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 FOR: Window/door
EGA I UEMEN
T LOCATION
Address:
Legal Description:
Property Tax ID #:
Site Plan Name:
Project Name: _
Setbacks Front
I REPLACE
Back:
WINDOWS &
Right Side: Left Side:.
DOORS WITH IMPACT. SIZE FOR SIZE.
Lot No._
Block No.
Haamonai worK to De errormea unaer tnis permit— cnecK aii apply:
11HVAC _ Gas Tank Gas Piping In Shutters a Windows/Doors
11 Electric ❑ Plumbing Sprinklers FIGenerator F]Roof Roof pitch
Total Sl. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ Utilities:cnSewer 11Septic Building Height:
Name
Address:
City: State: FL
Zip Code: Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name:
Company: FHiA LLc
Address: 3044 SW 42ND STREET
City: HOLLYWOOD
Zip Code: 33312
Phone No. 954-884-3500
E-Mail:
State or County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
Fax:
State: FL
DESIGNER/ENGINEER: x
Not Applicable MORTGAGE
CON±PANY: X Not Applicak�ie
Name: —
Name:
Addre�;s: Address:
City: - State: City: State:
Zip: Phone: -
_ Zip: Phone:
i
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: X Not Applicable
Name.
Name:
Address: Address:
City: City:
Zip: _ Phone: Zip: Phone:
I certifi,, 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 i i 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 the Florida Building
plans, 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 financin ult with !-ender or an attorney before
coX
mmencin ork or recordingour Notice of Commence _
S
Signature of Otivner essee ontractor as Agent for Owner Signature ntr ctor/License Holder
STATE: OF FLORIDA STATE OF FLORIDA
COUNTY OF 01. COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this /j_ day of 20 ZZ by this _ day of _ 20 by
+• I ����~ • • 4 WAYNE THOMAS BURNETT
(Name of person acknowle ging) I (Name of per n acknowledgin
I
(Signature of Notary Public- tate of Florida) (Signature of No Public- State of Florida )
Personally Known OR Produced Identification Person Known OR Produced Identification
_
Type o, Identification Produced T of identification Produced
ary PuD►rc }ate of Florida Commission No. NoanyP�cfFlorida
Fatthew Birkins A
Commission No. :Exp.
y Commission My Cwvnission HH 101140
Expires 04/19/2025
— — _
0f 8/23/2025
Revised 07/ 15/20
r" --
REVIEWS FRONT ZONING I SUPERVISOR I PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE — — -
COMPLETE
INITIALS