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HomeMy WebLinkAboutAPPLICATION FOR REPLACEMENT`t 1 a5 DATE: Ck 3 g: -zw IPF.RMTPNU , . r 1. LOCATIONJUHADDRESS: SanOS Ono.-OCAaA z. PARCEL IDNUMBER: /c(1SGOt;Oog 3000 3. DESCRIPTION OFPROJECT OR WORK ACTIVrrY: PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION 2360 mMinia Avenue Fort Pierce, FL 34982 (772) 462-1553 APPLICATION FOR REPLACEMENT OF WINDOWS, SKYLIGHTS, SWING DOORS, SLIDING GLASS DOORS & OVERHEAD GARAGE DOORS /( &to©(9000000 — PAW, 1 �I—AW11.� #FRS 4. TYPE OF STRUCTURE: SIR 1.1 MOBH E HOME OTHER i 5. OWNERSINFORMA_�ION A �SA 6• NDeri Y CONTRACTOR'SINMRMATION r 3c_/2-S9j.4I- Name: 3rr.o-S On OcEQn Address:'�(ob 0 MA city: N?;gw, , State: GP� Zip- Iq qq Phone: -11T-�{�vb•�2l'y EmaU: San05`3160 e/ Mgil-C40V- ���0 ? conaty cer t. �GP�yCO Business Name-QU+2 -. UQ�-12fiiLWtii WRir JG� Phone Number.5(Ql•�61•S7ob Email M� MewGL' aoo.Tc.0 0 Dr^ - COMPONENT ID. WINDOWS SKYLIGHTS 777M;; SLIDING GLASS DOOR ' SWING DOOR MULLIONS OVERHEAD GARAGE DOOR [] Attach 2 copies of the Product Approval with details to the product being used. 010 VALUE OF CONSTRUCTION: $ 5 t 15 FEES DUE: OwNER's AFPwAvrr: I certify that all of the information contained in this appiicatiGn is e and thatZaIHILbene in comp with all applicable laws reo lating contract an M PRINT OWNER OR CONTRAFrORIQUALWIM NAM SIGNTUREOFO OR CONTRAALII9ER MATE OF FLORIDA, COUNTY OF 5 _k,I�`'��'t KENO_------- --T7ETHI8�� DAY OF C.201 A'H IS PERSONALLY KNOWN WHO HAS PRODUCED AS IDENTIFICATION. .� ��, GNATURE OF N E O PRINT NAME OF NOTARY (j SEAL TTTLE: NOTARY PUBLIC COMUHSSION NUMBER �%� q 4 2 6 4 I NOTICE To OWNER: FAILURE TO TJMM A NOTICE OF CMeMCMdMT MAY RESULT IN YOUR PAYING TRICE FOR IIIIRLOVEMENTS TO YOUR PROPERTY. IF You INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR IMMER OR YOUR NOTICE OF COMMWCMdMT. ""� JAMESAREEVES t�'``$'t= Nrconaaiss�oaeoostzsvt Y: �.>a IXPWES:Jmre 1, 20t4 ,?„N• �4•' 9aNc-0Tlw Natay PUEBeUM�% - ST. LUCIE COUNTY Vinyl Siding INSTRUCTIONS Please complete all information in the space provided All information must be Printed lose black or blue ink only) or Typed This application for replacement of Windows, Skylights, and Doors is to be used only for those activities that are not otherwise included under a primary building permit This application for Permit may not be used for any activity that includes any type or kind of stmctmal alteration. Building activities involving struchual alteration, in addition to the replacement of Windows, Skyhgb% Doors & Overhead Garage Doors, must be permitted through the regular building permit review process. The information to be provided with this application includes: 1. LOCATION(SITE ADDRESS :............................................. Indicate the street address, or general location, of the property on which the building activity is taking place. 2. PARCEL ID NUMBER........................................................ Indicate the Property Tax Identification Number for the property on which the building activity is taking place. 3. DESCRIPTION OF PROJECT OR WORK ACTIVITY........ Briefly describe the building activity under permit application. 4. OWNERS INFORMATION .................................................. Indicate the name and address of the owner of the property on which the product is to be installed 5. CONTRACTORS INFORMATION: 6. VALUE OF Indicate the State of Florida (if applicable) and St Lucie County contractor's registration numbers, and the name of the business doing the work Indicate the total value of the work to take place. Total cost of construction includes all material and labor costs associated with the building/construction activity. The value of construction is used to determine the amount of permitting fees to be assessed St Lucie County reserves the right to question and/or modify the indicated value of construction if it is demonstrated that the submitted figures are not consistent with similar types of construction All applications for Permits are to be submitted to the St Lucie County Building and Zoning Department, St Lucie County Administration Building, 2300 Virginia Avenue, Fort Pierce, PL 34982. All applications for Permits must be completed and filed with the Department no later than 4:30 PM each business day. No applications will be accepted for processing after 4:30 P.M. For assistance in completing this application, please contact the St Lucie County Building and Zoning Department, at (772) 462-1553, during regular office hours (8:00 AM - 5:00 PM), Monday through Friday. Following the issuance of this Windows, Skylights, Doors & Overhead doors replacement Permit, the scheduling of all required inspections maybe made by calling (772) 462-1261. SLCCDV FORM NO: 006-05 Revised 4/102012 PDSD IC