HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL AF
Date:
INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
RECEIVED
AUGA 31m1
t
Application Building Permit An oepart ent
1 p PermittLucie coun
Plann ng and Development Services St. t�^
Buildi g and Code Regulation Division SCANNED
2300 firginia Avenue, Fort Pierce FL 34982 BY
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential ��CIO C,08f`
PERMIT APPLICATION FOR: Window/door
PROOIQSED IMPROVEMENT LOCATION:
Addre : 1 � r� �,�y��►-,r�s� �a�� 4- 41-_ L.� �'1e. Fl �cl95lia
Legal E 11� scription: c i A C, ew
Propeiy Tax ID #: I - q0 2 - cD O a a - o L c-) - 9 Lot No. ;Z,2
Site PI n Name: Block No.
Projec I Name:
Setbac'Iks Front I Back: _:5 Right Side: _� Left Side:
I
DETi�ILED DESCRIPTION QF`WORK
REPLACE 5 WINDOWS & S DOORS WITH IMPACT. SIZE FOR SIZE.
CONSTRUCTION INFORMATION:
Additi1nalwor tobe erformed under this permit -check a t 8t app y:
❑ VAC Gas Tank []Gas Piping _ Shutters Q Windows/Doors
Ellectric 0 Plumbing ❑ Sprinklers ❑ Generator ❑ Roof Roof pitch
Total q. Ft of Construction: S . Ft. of First Floor:
Cost o Construction: $ 3 `i L�"1 �e . 00 Utilities: Sewer ❑ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Namel — e Le. L
Name: WAYNETHOMASBURNETr
Addre s: c,,N v1 3a4
Company: FLORIDA HOME IMPROVEMENT ASSOC.
City: State: FL
Address: 3044 SW 42ND STREET
Zip C cle: -y9 Z1P Fax:
City: HOLLYWOOD State: FL
Phon j No.n Li 4 --s
Zip Code: 33312 Fax:
E-Mai :
Phone No. 954-792-4415
Fill in simple Title Holder on next page (if different
E-Mail: PERMITS@FHAPRODUCTS.COM
lee
from the Owner listed above)
11
State or County License: CGC#061890
If valuolof construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUP
'914 L CONSTR,UCTIC N LIaEN IAW INFORMATION.`,.
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DESI
Name
Addr
City:
Zip:
NER/ENGINEER: x Not Applicable
MORTGAGE COMPANY: x Not Applicable
Name:
Address:
City: State:
Zip: Phone:
ss:
1 State:
p Phone:
FEE SI'VIPLE
Name
Address:
City:
Zip:
TITLE HOLDER: x Not Applicable
BONDING COMPANY: x Not Applicable
Name:
Address:
City:
.1
Phone:
Zip: Phone:
I certi that no work or installation has commenced prior to the issuance of a permit.
St. Luci' County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which i in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structu ie. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In cons eration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in acco ;dance 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,
accessc�iiy structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WAR I ING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
impro tements to your property. A Notice of Commencement must be recorded and posted on the jobsite
befor(the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording your Notice of Commencement, /I
r as
Hol
STAT 1OF FLORIDA STATIE10F FLORIDA
COU I Y OF 57 L\XAF COUNTY OFF
The fo "going instrument was acknowledged before me
this b day of AQGOST- 20 116 by
l Liu
(Name $f per ac no g) 11
(Signai.Ore of Notary Public- State of Florida )
Ily Known Y_ OR Produced Identification
Type
�oW P47+ Notary Public State of Florida
CommLion No. Francisco M' 0a
�„ v y ommission GG 139459
T Expires 08/29/2021
07/15/2014
The f r oing instrument was acknowledged bef re me
this __L.L day of '� 20 Yy
WAYNE THOMAS BURNETT
(Name of person ackgPw ing )
of Florida )
alWown _/*�c_ OR Produced Identification
ion No. ,�'►"' MIGI*" MERCADO
c W COMMISSION # GG095745
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