HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 ad q Permit Number: 1164-
RECEI\ D APR2S, N17
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 X Residential
PERMIT APPLICATION FOR: Shutter
PROPrC►SED Il1/IPROVEMENT;LOCATION;
Address: 9550 S OCEAN DR 201
Legal Description: ISLANDIA I CONDOMINIUM UNIT 201
Property Tax ID#: 4502-601-0005-000-3 Lot No.
Site Plan Name: Francis L Sabina Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DES�RIRTION OF WORK y
Install 2 Accordion Shutters
CONSTRUCTION INFORMA1'lON h t
Additionalwork toe nertormed under this permit—check all appy:
❑HVAC Gas Tank E]Gas Piping V Shutters ❑Windows/Doors
11 Electric ❑ Plumbing Sprinklers ❑Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction: $ 8114.00 Utilities:cn Sewer E]Septic Building Height: 170'
,,OW ER/ _ CONTRACTOR:`
Name Francis L Sabina Name: Michael Heissenberg
Address:9550 S OCEAN DR 201 Company: Expert Shutters
City: Jensen Beach State:FL Address: 668 SW Whitmore
Zip Code: 34957 Fax: City: Port St Lucie State:FL
Phone No.561-212-0403 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 CNSTFtUCTIQN LIEN LAW INFQRMATION F
e
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: WalterTillit Name:
Address:6355 NW 36th St Address:
City: Virginia Gardens State: Ft_ City: State:
Zip: 33168 Phone: 305-871-1530 Zip: Phone:
FEE SIMPLE TITLE HOLDER: X 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 o n torney !fore
commencingwork or rec rd p o r Not` e of Commencement. i
s
_Signature of Owner/Les /Agent Signa re of Contract License Holder
STATE OF FLORIDA Lu
�j' STATE OF FLORIDA �� ���
COUNTY OF C COUNTY OF ( l
The for oing instrument was acknowledged before me The forgoing instr ent was acknowledged before me
this�lday of_ a ort ) 20 17 by this)c),!'day of i i 20 by
Michael Heissen4g Michael Heissenberg
(Name of person acknowledging) (Name of person acknowledging)
`
cv_,"�
(Signature of NotaryPub c-State of Florid ) (Signature of Notary Publ' -State of Florida)
Personally Known . OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
y�SFvZY`5;as a1 HER VI?)° � :r c^TH Vi
',
NOTARY Commission No. ) rri:l.`•:='
Commission No o;�`.'.;( a1}� / a (Seal) r !-3Ll
G, -2 STATE OF FLOR.OA A
Cornm#FF17 Aar•, s
t��" Expires 11/13/2018 L=;:)1;res .��;o'�;:,' 18
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS