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INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED }}
Date: ! Permit Number: 1 2—-
n 453
RECEIVED
Building Permit Application DEC B 3 2019
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Shutter
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Address: W)WO 5. OQU)4 1DeNe,, Noll- IWCA -
Legal Description: `nryAorfy%CNiUM Onii- loci, Nna �ndiu Si r�r� rY1t7t"�
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Property Tax ID#: �l511-5k�o-0103 - Lot No.
Site Pian Name: Block No.
Project Name:
Setbacks Front ✓� Back: Right Side: Left Side:
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"d° ":i^`'. 5 x�„�,3 & "''* '�` �''F^cf.v�•b S'.,�s^ ',�..,` '� w t
itiona wor to enertormed under this permit-cneCK all tm appy:
HVAC Gas Tank ❑Gas Piping Y Shutters Q Windows/Doors
Electric Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: SQ. Ft.of First Floor: r
Cost of Construction:$(9�Z-M Utilities Sewer Septic Building Height:
5^ k
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Name Name: Michael Heissenberg
Address:iC? a,fes J. � �t�' � IbCiCQ Company: Expert Shutter Services
City:� _50n QDQ0.� State:'R_ Address: 668 SW Whitmore Dr
Zip Code:��1t�-' Fax: City: Fort Saint Lucie State:FL
Phone No. �-- - tom\ 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.
SlJ'PP�I MEf�fiAL CONSTRUCTIONa LI I lAW IN1=(?RMANT
3
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DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Tiitecolnc. Name:
Address:6355 NW 36th St Suite 305 Address:
City: Virginia Gardens State: FL City: State:
Zip: 33166 Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x 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 attor before
commencingwor rd' our b tice of Commencement. /
10
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Signa a of Owner Le see/ ontract r iy Age or Owner Signature of Contractor/License FroldO
STATE OF FLORIDA STATE OF FL IDA
COUNTY OF �„ tp COUNTY OF -IwW
The forgoing instruLnent was acknowledged before me The forgoing instrument^was acknowledge;-�efore me
this_&day of 20 �by this of C- 20 l ! by
Michael Heissen4rg Michael Hsissenberg
(Name of person acknowledging) (Name of person acknowledging)
&WDt__ N( 71AQA_ S�S� 0 '(��
(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(1/
Commission No. �oSpRY(S al6anon O'Shea Commission No (mac 6 oP�o + �o� NO non O'Shea
aQ NOTARY PUBLIC y TARP PUBLIC
9
0o E OF FLORIDA '� ?Comm#GG25803
Revised 07/15/2014 Comm#GG258038 iyCE 19�e'
fiver I Expires 9/12/2022 Expires 9/12/202
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS