HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 6
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Date: CQ I�. 1�7 Permit Number: ay
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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: To Select from dropbox, click arrow at the end of line
'PR6POSE01111IR01lEMENT LOCATION rR fl k f y y
Address: 2405 RIVER BRANCH DR
Legal Description: RIVER BRANCH ESTATES LOT 28
Property Tax ID#: 3404-809-0032-000-5 Lot No.28
Site Plan Name: Block No.
Project Name: RICHARDS
Setbacks Front Back: X Right Side: Left Side:
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INSTALL 1 ACCORDIAN SHUTTER
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Addition a wor toe e orme under this permit-check l a appy:
HVAC E]Gas Tank ❑Gas Piping Shutters Q Windows/Doors
DElectric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: Scl. Ft.of First Floor:
Cost of Construction:$ 3,254.00 Utilities:0 Sewer Septic Building Height:
O�ti1�lERjLESSaEE'f �x F ��"'�� � �. 4', CONIRACTC?R f
Name KEN AND MICHELE RICHARDS Name: Michael Heissenberg
Address:2405 RIVER BRANCH DRIVE Company: Expert Shutter Services
City: FORT PIERCE State:FL Address: 668 SW Whitmore Dr
Zip Code: 34981 Fax: City: Port Saint Lucie State:FL
Phone No. 7 Q y(, y— 3 3 /'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.
5iJPPLEMENTL';CON5` RUCTlN LIEN LAW INl^QRMATIONi
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 ou intend to obtain financing, consult with lender or an attorneZbetf re
commencing work or rdin Notice Commencement.
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Signature of Owner/Less Contr ctor as A ent fo 0 ner Signature of Contractor/Lice a Holde
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF f—:� COUNTY OF Csr' t- ► 1 ('-t -,(--
The
CThe forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this o-_-3day of 3\-Ay-NC 20 )1 by this M day of It-Ay-)(C 20 1"l by
Mir.in oA kAA�GSenype- kA_LaS&4E�Y-)
(Name of person acknowledging) (Name of person acknowledging)
(Signature tary Public-State of Florida) ( ignature of No ary ublic-State of Florida)
Personally Known Oz- OR Produced Identification Personally Known �R Produced Identification
Type of Identification Produced Type of Identification Produced
a l
�—A�—1���3� ) Haieigh Russell / G� &NOTARYPUBILH:
Commission No al Commission No�1G`�l 06 Iq
NOTARY PUBLIC STATE OF FL A
Comm#GG1083
Revised 07/15/2014 Comm*GG108398 qWV Expires 5/25/2(21
Expires 5/25/2021
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS