HomeMy WebLinkAboutBUILDING PERMIT APPALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
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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
1f111€NT LQCATION. = r z
Address:
Legal Description:
Property Tax ID #:
Lot No.
Site Plan Name:
Block No.
Project Name:
Setbacks Front Back:
Right Side: Left Side
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REPLACE WINDOWS &
DOORS WITH IMPACT. SIZE FOR SIZE.
s
_ to e e ,orme un er t Is permit — c ec al apply:
Additional work
I�HVAC Gas Tank
Gas Piping Shutters Q Windows/Doors
Electric ❑ Plumbing
Sprinklers Generator Roof Roof pitch
Total S,i . Ft of Construction:
Sq. Ft. of First Floor:
11
Cost of. Construction: $
Utilities: Sewer Septic Building Height: _
CONTRACl'OR» . -
Name
Name:
Address:
Company: FHIA LLC,
City:
State: FL
Address: 3044 SW 42ND STREET
City: HOLLYWOOD State: FL
Zip Code: Fax:
Phone No.
Zip Code: 33312 Fax:
E-Mail:
Phone No. 954-8848500
_
Fill in fee simple Title Holder on next page { if different
E-Mail: PERMITS@F HIAREMODELING.COM
State or County License:
from taie Owner listed above)
If value. of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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
Name: _
Address:
City: _
Zip:
Phone:
BONDING COMPANY:
Name: _
Address:
City:_
Zip: _
Phone:
X Not Applicable
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 perinit 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 Commer
improvements to your property. A Notice of Commencement
before the first inspection. If you intend to obtain financing, c
commencing work or recording; vour Notice of Commencemen
Si ature of Owner/Lessee/Contractor as Agent for Owner Signature
STATE OF FLORIDA/
COUNTY OF S 4-Cwkt
The forgoing instrument was acknowledged before me
this V day of 'L , 20 Eby
shy P"4
t may result in your paying twice for
recorded and posted on the jobsite
th Iinder or an attorney before
STATE OF FLORIDA
COUNTY OF
tense H
The forgoing instrument was acknowledged before me
this day of ___ 20 _ by
WAYNE THOMAS BURNETT
(Name of perso /ledging) (Name of person
(Signature of Notary Public- State of Florida )
Personally Known OR duced Identification
Type of Identification Produced
(Signature of
wKnown
entificati
y'Public- State of Florida )
A010*013 Produced Identification
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�40 Notary Public State of Florida
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Commission No. (Seal) Commission No. Miguel A &We;
y Commission HH 101149
41 Expires 04/19/2025
o�°� Notaryp °pP'
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irkins
sssasRevised 07/1 MC
EXp, 8/23/2025
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