HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO/MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �' %• /7 Permit Number: 1701,- 0411
RECEIVED
Building Permit Application
Planning and Development Services JUN 19 9 2017
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
I'aRtURO tb4W`IROUEM EI T 0#*( r .....
Address: 12961 S INDIAN RIVER DR
Legal Description: 4 37 41 FROM A PT ON W BANK IND RIV 335 7/12 FT N OF S BDRY OF SEC,RUN SELY ALG RIV 60 FT M/L TO POB,TH SWLY TO E RNV
FEC RR,TH SELY ALG R/W 140.30 FT,TH NELY TO RIV,TH NWLY MEANDERING RIV TO POB-LESS SR 707(OR 11138-29113;3179-1760)
Property Tax ID#: 4504-340-0008-000-0 Lot No.
Site Plan Name: Block No.
Project Name: REEVES
Setbacks Front.X Back: X Right Side: X Left Side: X
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INSTALL 10 ACCORDIAN SHUTTERS
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Itlona wor to e e orme un er t Is permit—c
eck all appy:
HVAC Gas Tank ❑Gas Piping �_Shutters Windows/Doors
Electric um ng Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ 6,560.00 Utilities: Sewer E]Septic Building Height:
C � Ei /LS � ro k . � G CQNTRA R`§
Name EDWARD REEVES Name: Michael Heissenberg
Address:12961 S INDIAN RIVER DR Company: Expert Shutter Services
City: JENSEN BEACH State:FL Address: 668 SW Whitmore Dr
Zip Code. 34957 Fax: City: Port Saint Lucie State:FL
Phone No. s43 (o Z c7 ' CJ 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.
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SI��PPLE�MENLCL7N5TRUCTIOtU LIE�LAW INFt�RMATIt7N � } �
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:
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 ins a 'on. If you intero to obtain financing, consult with lender or an attorney before
tommencing,wofkor rec4rdirlR youyAotice of Commencem
s
Sigh'ature of Owner essee/Contractor as AgEynt for Owner Signature of Cont or/License Holde
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF_. L_t 6 COUNTY OF -3h- L A 1 CJI •C
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this(�n day of J1 Af_)C 20 t-1by this CIday of AAV-Ne-_ 20 .La by
(Name of person acknowledging) (Name of person acknowledging) _—
Signature o No ary Pub ic-State of Florida gSlghature of NC&Y
Public-State of Florida)
Personally Known OR Produced Identification Personally Known V OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No IONS &. I—
)VOh Russell Commission No q ( jgh Russell
STATE OF FLORI NOTARY PUBLIC
STATE OF FLORIDA
/q108399 ?Comm#GG10B399
Revised 07/15/2014 e�Vrft 5/2512021 t Expires 5/25/2021
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS