HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 9
Date: li7 • �� Permit Number: / ,7D6A 7
RECEIVED
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Building Permit Application JUN 19 2017
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
SED
Address: 6905 COQUINA AVE
Legal Description: LAKEWOOD PARK-UNIT 9 BLK 105 LOT 16
Property Tax ID#: 1301-611-0094-000-8 Lot No.16
Site Plan Name: Block No. 105
Project Name: KELLER
Setbacks Front Back: X Right Side: X Left Side: X
.ky r,,.. 4 717"' t';
INSTALL 5 ACCORDIAN SHUTTERS
� ��I�TR�1C1'IC�
Additional work to be nertormed under tispermit–check all appy:
HVAC Gas Tank []Gas Piping Shutters ❑Windows/Doors
Electric 0 Plumbing Sprinklers Generator 1:1 Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 3,018.00 Utilities:Sewer Septic Building Height:
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C?NTI�
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Name BARBARA KELLER Name:- Michael Heissenberg
Address:6905 COQUINA AVE Company: Expert Shutter Services
City: FORT PIERCE State:FL Address: 668.SW Whitmore Dr
Zip Code: 34951 Fax: City: Port Saint Lucie State:FL
Phone No. -7L —L(2-,q— 7 96,z— Zip Code: 34984 Fax: 772-871-0990
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 CONSTI�CTION LILAW INI=QRMATIt7NRb" b �
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 yo intend to obtain financing, consult with len or torney before
commencing work orT"qrcri6g yAuLhWice of Commencement.
s
Signature of OW-ner/Lessee/Contrac rAgent f Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ` COUNTY OF l Ca G�
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this(�Mday of fly 20 Jaby this[X-6 day of �J_),V- 120 L by
(Name of person acknowledging) (Name of person acknowledging)
Signature of of ry Pub' -State of Florida) ( ignature of Not ry Public-State of Florida)
Personally Known 7OR Produced Identification Personally Known ,/OR Produced Identification
Type of Identification Produced Ha1e1 h RUssd Type of Identification Produced
5 NOTARY PUB IC �y� A%"N
h Russell
Commission No. STATE OF FL RQlwmission Nor-a6-1 1023Comm#GG108 99 OTARY PUBLIC
STATE OF FLORID
Revised 07/15/2014 E)Ores 5/25/2021
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
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