HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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Building Permit Application JUN_I r®
Planning and Development Services t S Ing De
rtin
Building and Code Regulation Division 1JC1e Counivenr
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 LOCATION:
Address: 9331 AVENEL LN
Legal Description: PAINES AT THE RESERVE\A
Property Tax ID#: 3322-502-0020-000-5 Lot No.14
Site Plan Name: JOHN SANTACROCE Block No.
Project Name: JOHN SANTACROCE
Setbacks Front Back: 3 Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
REPLACE 2 WINDOWS & 1 DOORS WITH IMPACT. SIZE FOR SIZE.
CONSTRUCTION INFORMATION:
• Additional work to be erformed under this permit—check all apply:
".El HVAC IIGas Tank nGas Piping Shutters Q Windows/Doors
+ ElElectric ❑ Plumbing Sprinklers El Generator El Roof Roof pitch
. T
Total Sq. Ft of Construction: S . Ft.of First Floor:
-Cost of Construction: $ 3 cji Utilities: Sewer ElSeptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name JOHN SANTACROE Name: WAYNE THOMAS BURNETT
Address:9331 AVENL LN Company: FLORIDA HOME IMPROVEMENT ASSOC.
City: PORT ST LUCIE —State:FL Address: 3044 SW 42ND STREET
Zip Code: 34986 Fax: _ City: HOLLYWOOD State:FL
Phone No. v—lP.— T)\ — 4,^l LK 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
f
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: _Not Applicable
Name: Name:WAYNETHOMAS BURNETT
Address: Address:
City: State: City: HOLLYWOOD State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address:3044 SW 42ND ST 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 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 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 your Notice of Commence -
ilitt‘
Signa e of Owne nle ee/Contractor as Agent for Owner Si:nalip
• actor/License Holder
STATE OF FLORIDA 'TA 10,- `•RIDA
COUNTY OF 5cn,n I- (,v'Gfrt. C 6% NT OF
The forgoing instrument was acknowledged before me The fofgoing instrumPot was acknowledgie efore me
this 30 day of 5— , 206S by this I day of �dZ , 20Xby
-h t S V% GNP Cc
Name of perso making statement Name of p 'son making statement
Personally Known V OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
. /44,‘ ...--
•.. •► ..�.
(Signatt - • . - : _ - ( - - .
•,s," •.: MATTHEW B!RlCINS SI. �,:‘1.1 MIGUEL A McRC DOCommiso3 ,n_;r`:v MY COMMISSION#GG1i ) !• ion o MY COMMISSION# DO
I-,f, o",A• EXPIRES July 02,2021
EXPIRES April 19,2021
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17