HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I I w Permit Number:
Building Permit Application s,
Planning
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Building and Code Regulation Division � OAo ��a�
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial X Residential
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PERMIT APPLICATION FOR: Shutter
PROPOSED IM' 'EM'ENT LOCATCON
Address: 4949 N Hwy A1A#84
Legal Description: BREAKERS LANDING UNIT 84
Property Tax ID#: 1414-602-0024-000-6 Lot No.
Site Plan Name: Block No.
Project Name: Monk
Setbacks Front X Back: Right Side: Left Side:
DETAILED DESCRIPTION;OF WORK
Install 1 Accordion Shutter
C NSTRUCl'IC?.N INFORMA,T
�. ,
Additional worK to be nertormed under t ispermit-check a appy:
HVAC Gas Tank 0Gas Piping LJ Shutters Windows/Doors
11 Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 1,263.00 Utilities:Sewer Septic Building Height:
1NNERf LESSEE
CQ,NTRAGTOR
Name James A Monk Sr Name: Michael Heissenberg
Address:4949 N Highway Al Apt 84 Company: Expert Shutter Services
City: Fort Pierce State:FL Address: 668 SW Whitmore Dr
Zip Code: 34949 I Fax: City: Port Saint Lucie State:FL
Phone No.914-329-6087 Zip Code: 34984 Fax: 772-871-0990 j
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 abive) State or County License: 16572
If value of construction is$250' 0 or more,a RECORDED Notice of Commencement is required.
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SUP LEMENTAL CONSTRUCTION LIEN LAW INFORMATION'
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Tiltecolnc. Name:
Ad d ress: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.
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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 in nd to obtain financing, consult with lender or an attorney before
commencing wor r re in Y4/Notice of Commencement.
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Signature of Own er/Lessee/Contracto as Agent for Owner Signature of Contractor icense Holder
STATE OF FLO A STATE OF FLOR
COUNTY OF (� L.(-�l0A COUNTY OF s�
The for oing instrument was acknowledge efore me The forgoing instrument was acknowledged before me
this 11 day of c)an 20by this F) day of c lain 20 c,26 by
Michael Heissenb�rg Michael Hsissenberg
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Pu lic-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
Commission No. Nb (Se Shanon O'Sh aCommission No. ?03� VW.
I�Shanon O'Shea
tf+�gs NOTARY PUBLIC
� sn NOTARY PU LIC DA �� STATE OF FLORID
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e-rATS=QF Comm#GG2580380omm
Revised 07/15/2014 s� Vlq��
Expires 9112/2022 s1NCe1.1 Expires 9/12/2022
REVIEWS FRONT ;ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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