HomeMy WebLinkAboutWINDOW/DOOR INSTALLATION RESIDENTIAL ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ��D ��l Permit Number:
RECEIVrED AUG 15 2016
0
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Window/door
PROPOSED IMPROVEMENT.LOCATION:
Address: a f A+C h Q
Legal Description: 3.S --IC) FAN, w Cof�/edr, o,C 's C Ir h( ii V el ro
-!;4 Y yea I"
Property Tax ID#: OOC7 - �°' Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF K:
new ww(�Vs
vio
EONSTRUCTION INFORMATION:
Additionalworkto a er orme, under this permit-check all that appy:
❑HVAC E]Gas Tank Gas Piping Shutters Zinclows/Doors
F]Electric 0 Plumbing Sprinklers 1:1 Generator Roof. Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Gc/
Cost of Construction:$ Q -� Utilities: _Sewer[]Septic Building Height:
OWNER/LESSE,E: CONTRA-CtTOR:
Name ChAitlyc llAJy,✓ES Name: r AI( ( a4
Address: 3,1:7 1 Pa-�(7,110-r, S 1 Company: 7K e0*jXf
City: El C I LA C n State: FL Address: /Zo� S 0 Z) ( A-rn c) 2�
Zip Code: Fax: City: PpiZA SAt,o a- L.LAe,,t State:_JZL
Phone No. 6,33 - 9-q&/ Zip Code: _�g V!? 3--3 Fax:
E-Mail: Phone No. -7 7 -d c-,oCi
Fill in fee simple Title Holder on next page(if different E-Mail: !hFo ,9 g12 �X f��zc o6LS . Gd
from the Owner listed above) State or County License: ��,['_ %2�,,[) R7
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUJPPLEIVIENTAL CQNSTRUCTIQN LIEN LAW INFORMATION:
s� a:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: r 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 attorney before
commenciyg—wtxJ<or recording our Notice of Commencement.
s
Signature of Owner/Lessee/Contractor as Agent for Owner Signature o Contractor/License Holder
STATE OF FLORIDA STATE OF L
FLORID_A /
COUNTY OF 5-r Ci e- COUNTY OF S T- QC( -0
The forgoing instrumentwasacknowledged before me The fo going instru ent was acknowledged/before me
this�day of� 20 JL by this/ day of LA 20l(a by
Ila& r4q r ►�h �i �)r�S� c-J Qat VO,L 4
(Name of erson acknowledging) (Name of pn acknowled ing
e o )
(�Q
14
(Si ry Pub' -State of Florida) (Signatur ublic-S ate of Florida)
Pers nown ) �OR Produced Identification Pers all own OR Produced Identification
—E.G—
Type of Identification Prod Type of Identification Produced
'Ps'Ry°o Notary Pppblic State of Florida
Commission No. Jds`�15haneAlberico ommission No. ova Notar i State of Florida
PQ My Commission EE 827424 Joshua Shane Alberico
Expires 08/16/2016 My Commission EE 827424
OF n xpires 06/16/2016
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS