HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: LA �'� 1 � N U � �, Permit Number:
R E C E I\":D aP,�
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 X
PERMIT APPLICATION FOR: Shutter
PROPOSED IIVIPROVEMENT.LOCATIfQN
Address: 127 Queen Bess Ct
Legal Description: QUEENS COVE-UNIT 1- BLK 16 LOT J
Property Tax ID#. 1414-701-0154-000-0 Lot No.J
Site Plan Name: Delmar L Bullis Block No. 16
Project Name:
Setbacks Front Back: Right Side: Left Side:
D"ETAILE DESCRIPTION OF WORK
Install 7 Accordion Shutters
CONSTRUCTION 1NFORMATIO;N
.2a
Additional work toa er orme under this permit—check a appy:
❑HVAC E]Gas Tank E]Gas Piping Shutters ❑Windows/Doors
11 Electric ❑ Plumbing Sprinklers 1:1 Generator Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 2353.00 Utilities: Sewer Septic Building Height:
QWNER/LESSEE" CONTRACTOR: , F`
Name Delmar L Bullis Name: Michael Heissenberg
Address: 127 Queen Bess Ct Company: Expert Shutters
City: Ft Pierce State:FL Address: 668 SW Whitmore
Zip Code: 34949 Fax: City: Port St.Lucie State:FL
Phone No.772-940-9593 Zip Code: 34984 Fax:
E-Mail: Phone No. 772-871-1915
Fill in fee simple Title Holder on next page(if different E-Mail: callexpert@aol.com
from the Owner listed above) State or County License: 16572
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN
-LAW INFORMATIaN
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: WaiterTillit Name:
Add ress:6355 NW 36th St Address:
City: Virginia Gardens State: FL City: State:
Zip: 33168 Phone: 305-871-1530 Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x 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 thepermit 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 thie jobsite
before the first inspectio"yaQ intend to obtain financing, consult with lencler-oTM-51itorneAefore
commencin&work or rpcorefing kour N Bice of Commencemen
_ s
_Signature of Owner/I ee/Agent Signature of Contra c(Gr7License Holder
STATE OF FLORIDA j' J STATE OF FLORIDA LU l l
COUNTY OF �T. l ��/l C I COUNTY OF � L �A I
The forgoing instrument was acknowledged before me The forgoing instru ent was acknowledged before me
this L�day of Q Q r i 1 20 F)by this j 011 day of 20 !1 by
II �
Michael Heissen4g Michael Heissenberg
( me of person acknowledging) (Name of person acknowledging)
(Signature of NotaryPu ic-State of Florid (Signature of Notary Publ' -State of FI•r' )
Y
Personall Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced I
X-1 F=ATHER VIZ-70 Commission No-V: ���L 6, 01f(Seal�`�'�THER V1770
Commission �a� (Seal)" q r )
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Revised 07/15/2014 �fb=19�� Ir;,i:>,S s 1 /:.:,12'01$
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS