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Home My WebLink AboutAPPLICATION FOR REPLACEMENTDATE: 1 CEIPT: �\ PERMIT NU' CR 130 - PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION SCANNED By Fort Pierce, FL 34982 St. Lucie County (772) 462-1553 APPLICATION FOR REPLACEMENT OF WINDOWS, SKYLIGHTS, SWING DOORS, SLIDING GLASS DOORS & OVERHEAD GARAGE DOORS 1. LOCATIONISITE ADDRESS: c, ocEae� / )l oci � WA Fr. Pjiuc4, PL 311M 2. PARCEL ID NUMBER: % y S (� 0 6 o$ 3 a o 0 3 r (� 3. DESCRIPTYONOFPROJECTORWORKACTIVITY: �� FLti -7 �^"5,L,-Pw'S 4. TYPE OF STRUCTURE: SFR MOBILE HOME 5. OWNERSINFORMATION Name: GhDS pnt OC£.Or1 t.GnOa S( .✓ Address:3too AlA City: f I pi%zi- State: �L Zip: 349M Phone:l�� glob �21y Email: Sr V%0S '�900 e 31rAR l . Cor. 6. CONTRACTORS INFORMATION FLReg/Cert#: County Cert#: d� 3 Business Name 0 411LfclRl"Co"r Phone Number. s�1'y t' Q'i 00 COMPONENT ID. PRODUCT DESIGN PRESSURE PRODUCT APPROVAL # WINDOWS SKYLIGHTS SLIDINGGLASSDOOR SWINGDOOR. MULLIONS OVERHEAD GARAGE DOOR 0 — O f ( . O [] Attach 2 copies of the Broduct Approval with details to the product being used. VALUE OF CONSTRUCTION: $ 5 `o, FEES DUE: q5 . aG OWNEB,s AFFIDAVIT: I certify that all of the information contained in this application is correct and that all work will be done in compliance with all applicable laws regulating construction and zo� 5AW5 QN dA4-0C�C-A A i &ctl�il�� Lei +t3� f>RG& I PRINT OWNER OR CO RIQUALWIKK NAME _ SIGNATURE OF OWNER OR CONTRACTORIQUAI HUM STATE OF FLORIDA, COUNTY OF ACKNOWLIIDGED BEFORE METHIS�_DAY OF 20 13 .BY IC A?f� — —JA S PERSONALLYKNOWNTOMEO WHOHASPRODUCED AS IDENTIFICATION. k-� R. (Zl��.;� OF #OTARY TYPE OR PRINT NAME OF NOTARY SEAL TITLE: NOTARY PUBLIC COMMISSION NUMBER � q Z G R q NOTICE TO OWNER. FAILURE TO RECORD A NOTICE OF COMMENCE1000 MAY RESULT IN YOUR PAYING TWICE FOR INP MMIE 1TS TO YOUR PROPERTY. IF YOU nmw TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCIROM- ""ry,,q JAMESAREEVES yi MYC W1SSIDN#DD9099 ?P ` EXPIRES: June 1, 2D14 Bonded Thm Nobry Pubhc UndtWftM ST. LUCIE COUNTY Vinyl Siding INSTRUCTIONS Please complete all information in the space provided. All information must be Printed (use 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 structural alteration Building activities involving stmcmaal alteration, in addition to the repacement of Windows Skylights, 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 taldng 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 ..................................... Indicate the State of Florida (if applicable) and St Lucie County contractor's registration numbers, and the name of the business doing the work 6. VALUE OF CONSTRUCTION: ........................................... Indicate the total value of the work to take place. T0ta1 Cost 0f 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 Deparmeot, St Lucie County Administration Building, 2300 Virginia Avenue, Fort Pierce, FL 34982. All applications for Permits most be completed and filed with the Department no later than 4:30 PAL 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, daring 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: 066-05 Revised 4/10/2012 PDSD JC 1 ' 7 t ^. �1 I I: