HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 7
Date: 1.05- IT Permit Number: ,Id / 0 7-6c)
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Building Permit Application JUL 2 5 291?
Planning and Development Services FEE;?�,El-ri�!G
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential XX
PERMIT APPLICATION FOR: Shutter
PROPOSED IMPROVEMENT LOCATION:
Address: 4245 S Indian River Dr
Legal Description: 35 35 40 BEG AT PT ON W LI OF E 12 OF NE 1255.36 FT N OF S LI OF SE 1/4 OF NE 1/4,TH RUN N 100 FT,TH E TO RIV,TH SELY ALG
RIV TO PT 1255.36 FT N OF S LI OF SE 1/4 OF NE,TH RUN W TO POB WITH RIP RTS-LESS RD AND FEC RR-4245 S Indian River Dr
Property Tax ID#: 2435-113-0007-000-8 Lot No.
Site Plan Name: Block No.
Project Name: Bloehm Residence
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF F WORK:, ,
dyi o Ta r2 2.
CONSTRUCTION INFORMATION:
Additional work to ff.ZsiJnJ
rme un er t Is permit—c ec a appy:
11HVAC ' '`i`' Gas Piping Shutters,;.:: i % r WiKdbvusDoors
Electric 0 Plumbing ❑Sprinklers 11 Generator E Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ J 1, a Utilities:cnSewer 0Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Rosalie Bloehm , Name: Edward J Heritage
Address:4245 S Indian-R,iver; Company:`Folding Shutter Corporation
City: Fort Pierce State:FL' Address:,'
ddress 7089 Hemstreet;Pl
Zip Code: 34982, , . .F,ax: : ` Cit West,Palm;Beach.-? t _. FL
City: State:
Phone No.772-461-16562 Zip Code:`33418 "" ' ;Fax: 561-640-8204
E-Mail:n/a Phone No. 561-683-4811
Fill in fee simple Title Holder on next page(if different E-Mail: info@foldingshutters.com
from the Owner listed above) State or County License: SCC131151041.
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize thepermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
_ s
Signature of Owner/Lessbe/Coater as Agent for Owner Signature of Contra ctor/_Cice_me-ft
fder
STATE OF FLORIDA STATE OF FLORIDA -
COUNTY OF PALMBEACH COUNTY OF PALMBE4CH
The forggoing instrumea.Lwa$acknowledged,t�efore me The forgoing instrument was acknowledged before me
this L day of J '�i!2 20 JJ by this 1 I day of Jy� 20 by
Edward-3: Heritage . EdWard-=3. Heritage
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
FF I SO`&? PAMELA A.EVANS
Commission No. PAMg6AaQ�.EVANS Commission No. o1�Y'�ss RY PUB��LEaI)
NOTARY PUBLIC 1-F(50�7 �� -�S1ATEOF-FLORIDA___
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Revised 07/15/2014'si ,0i Comm#FF150967 Ys�NcE Ir Expires 1011112018
hCE t9 Expires 10/11/2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW- REVIEW
DATE -------"
COMPLETE
INITIALS