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7 All APPLICABLA INFO MUST BECO PLETED FOR APPLICATION TO BE ACCEPTED
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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
PERMIT TYPE:Building
PROPOSED IMPROVEMENT LOCATION:
Address: 9500 S Ocean Dr Unit 1710,Jensen Beach, FL 34957 j
Property Tax ID#: 4502-602-0164-000-8 Lot No.
Site Plan Name: Block No. li
Project Name: Glen&Marie Branciforte
[DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
Additional work to be performed under this permit–check all that a:Zhutters'
_Mechanical _Gas Tank _Gas Piping _Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ g� Utilities: —Sewer —Septic Building Height:
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OWNER/LESSEE: CONTRACTOR:
Name Glen&Marie Branciforte Name:Edward J.Heritage
Address:9500 S Ocean Dr#1710 Company:Folding Shutter Corporation
City: Jensen BeachState:_ Address:.18ti21,,Dr Martin,Luther.-King Jr Blvd
p, . ....34957`+' -' 'Fax:N/A City: West Palm Beach '( State:FL .
Zi Code: r:.
Phone No 860 4'16:0831 Zip Code;_:33404 " Faz: 561-640-8204
E-Mail:applepieglen@icloud.com Phone No 561-683-4811
Fill in fee simple Title Holderon 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.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
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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:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner see actor as Agent for Owner Signature of Cnnt�tor/Lice ise44`etder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY O F Pa m beach COUNTY OF Faun Beach
The forgoing instrument was acknowledged before me The for oing instrument was-acknowledged before me
this R'3 day of dcT ,2011 by this day of 1 20_ by
Edward J.Heritage Edward J.Heritage
Name of person making statement. Name of person making statement.
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Type of Identification
Produce Produce
G-�a�Gam-• �� ���G�
(Signature of Notary Public-Stats ofll l WA Evans (Signature of Notary Public-StatAe�Qf Flor'
�f$t�la A.Evans
Q s�o NOTARY PUBLIC Q �� N A PUBLIC
Commission No. o Commission No.
?$. �STA�'L'��FLORIDA p4 S �F FLORIDA
l ?Comm#GG262789 �G''��'��
,�Comm#GG262789
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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RECEIVED
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