HomeMy WebLinkAboutAPPLICATION FOR PELACEMENT - WINDOW - DOORSstk
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
p BUILDING & CODE REGULATIONS DIVISION
G a _ 2300 Virginia Avenue SCANNED
Fort Pierce, FL 34982 BY
462-1553 St. Lucie County
APPLICATION FOR REPLACEMENT OF
WINDOWS, SKYLIGHTS, SWING DOORS, SLIDING GLASS DOORS
& OVERHEAD GARAGE DOORS
1. LOCATION/SITEADDRESS: lt7i0 S- OUAVg DJ • r t1u. i,
2. PARCEL ID NUMBER: 3SZZ•U01-Oo23.boo- 3
3. DESCRIPTION OF PROJECT OR WORK ACTIVITY:
IInS-b'11 Vvi40Liu
4. TYPE OF STRUCTURE: SFR MOBILE HOME OTHER M LL 14i
S. OWNERS INFORMATION
Name: GW KN'r 1'b }ln I C tV V& .C..
Address.—I4 W S - Ol,t-&. by'. * th it ' t
City: f t, U L i-k- State: Pt -
Zip: Phone:
Email:
6. CONTRACTOR'S INFORMATION
FL Reg/Cert #: C gC 0 Sq 3.51
County Cert #:
Business Name- ('(kC'/ I4V^ t3-D- k('VC In c-
PhoneNumber: &Ul' 3301-'11t0
Email:
COMPONENT ID.
PRODUCT DESIGN PRESSURE
PRODUCT APPROVAL #
WINDOWS
SKYLIGHTS
SLIDING GLASS DOOR
SWING DOOR
MULLIONS
OVERHEAD GARAGE DOOR
[] Attach 2 copies of the Product Approval with details to the product being used.
VALUE OF CONSTRUCTION: $ 41 0 ' `t v FEES DUE:
OWNER'S FIDAVIT: I certify that all of the information contained in this a on is correct and that al ork will be done in
compliance with all app'pable laws regulat' nstruction an zoning.
PRINT OWNER OR CONTRACTOR/QUALIFIER NAME SIGNATURE OF OWNER OR CONTRACTORIQUALIFIER
STATE OF FLORIDA, COUNTY OF f al M -P'C"V` I- ,,
ACKNOWLEDGED BEFORE ME THIS 2 DAY OF Uu 4 y , 20 (t . BY � `t vY � (,k&y (l,,' U�
WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED DLIILMICATIONc --
13�gQt,�id�ll?IE CIC9MALy�"
SIGNATU OF NOT Y TYPE OR PRINT NAME OF NOTARY ^;_ MY gE Ati§919N 4 9EQ06826
EMIR58 Moy 23, 2015
TITLE: NOTARY PUBLIC
COMMISSION
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.