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Date: / Permit Number: I LA 6 i Ea
IMM A
RECEIVED
Building Permit Application JAN 2 12016
Planning and Development Services PERMITTING
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line W i , a r
PROPOSED IMPROVEMENT LOCATION:
Address: 2409 Elizabeth Ave
Legal Description: Fleetwood acres, blk 3 lots 1 and 2
Property Tax ID#: 2428-604-0037-000-2 Lot No.
Site Plan Name: Block No.
Project Name: sliding door replacement
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
replace a damaged sliding door with a new non-impact sliding door
CONSTRUCTION INFORMATION:
Additional work toe ertormed under this permit—check all appy:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
0 Electric El Plumbing Sprinklers q Generator Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ 1,200.00 Utilities: Ll Sewer Septic Building Height:
OWNER/LESSEE; CONTRACTOR:
NameFNMA Name: John Zervopoulos
Address:2424 N Fed Hwy Ste 360 Company: Advanced Hurricane Protection
City: Boca Raton State:171 Address: 4517 SE Commerce Ave
Zip Code: 33431 Fax: City: Stuart State:Fl
Phone No.772-220-1200 Zip Code: 34997 Fax:
E-Mail: Phone No. 772-220-1200
Fill in fee simple Title Holder on next page(if different E-Mail:john@advancedhurricane.net
from the Owner listed above) State or County License: CBC259339
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 attorne before
commencing work or recordin Notice of Commencement.
S�;! .e� s
ignature caner/Lessee/Agent Si
re ZCoctor/LiceFs-e Holder
6O LORIDA DA
COUNTY OF TY OF LUC
The for oing instr Tent was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20 ( by this o"l day of Y 20 *by
�' (g1�t�l ZEI�v��� 0)Ul--csS ��' V0 p ,
(Name of person acknowledging) (Na a oilpqerson acknowledging)
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(Signature of Notary Public-State of Florida) (Signat re of Notary Public-State of Florida)
Personally Known OR Produced Identification ✓ Personally Known OR Proddu ed Identification
Type of Identification Produced �(, {� Type of Identification Produced �—( �•0--•
Commission No.t-cl I'S to fission No. F a REN S. NIELSE
KAREN S. NIELSEN �:`RYP�'�':
c Commissio;i# FF 1156
e Commission# FF 11 637 =* *_
My Commission Expir
y Commission LXpires :�EOFF,��,�` June 12, 2018
Revised 07/15/2014 June 12, 2018
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