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ALL APPLI ABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �• �� Permit Number: ' Q
RECEIVED
Building Permit Application Nov 12 201
Planning and Development Services 9
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential XXX
PERMIT APPLICATION FOR: Shutter
PROPOSED IMPROVEMENT LOCATION:
Address: 18503 Mach One Dr-Fort Pierce
Legal Description: Aero Acres Blk 1 Lot 21
Property Tax ID#: 3215-801-0028-000-0 Lot No.21
Site Plan Name: Block No. 1
Project Name: Hammer Residence
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
Additional work toe nerformed under tispermit–check all that appy:
E]HVAC Gas Tank ❑Gas Pig WShutters_ Windows/Doors
— pin ❑
Electric 0 Plumbing Sprinklers ❑Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ XJ 96 Utilities:cn Sewer[]'Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name.Lynda:&Jeffrey Haniiner. Name: EdWEird J Heritage.
Address:•18503,-Mach'One.Dr - Comp any Foldmg:Shu6erQ-orporation
•�-5_ !-1
City:-'Fort Pierce ='=% State:F�' Address-'1862 Dr'Marf'in'Luther King Blvd '
Zip Code: 34987" Fax:n/a City: West,Palm-Beach'" State:FL
Phone No.612-817-2119 Zip Code: 33404 Fax: 561-640-8204
E-Mail:jeffandlyndah@hotmail.com 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 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 you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
s
Signature of Owner/Le oras Agent for Owner Signature of Con or/Li older
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF PALM BEACH -COUNTY OF PALMBEACH
The for oing instrumeggt��was acknowledged efore me The forgoing instrument was acknowledgedbeforeme
this day of Nd V 20 (1by this 7 day of 20 1 ( by
EDWARD J HERP�AGE EDWARD J HERITAGE
(Na erson 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 PAMAIR a Ewana—
t a vans
Commission No. Q y �s TARY PUBLIC Commission No. o °o�IO PUBLIC
�S oZ G�79, STATE OF FLORIDA / c SETA E OF FLORIDA
NIA-l"
Comrn#GG262789 C��S "�7S 9 Comm#GG262789
E Expires 10/11/2022 IV. Expires
10711721022
Revised 07/15/2014
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