HomeMy WebLinkAboutBuilding Permit Application ALL APPLICA LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED At')
Date: I (,l'1 Permit Number: L/of — 0
Building Permit Application
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 X Residential
PERMIT APPLICATION FOR: Shutter
P.kb, PQSED IiVIPROVEMENT.LO.CATION
t,
Address: 5051 N Highway Al#4-3
Legal Description: SEAWARD AT ATLANTIC VIEW UNIT 4-3
Property Tax ID#: 1414-612-0013-000-7 Lot No.
Site Plan Name: Block No.
Project Name: Brooks
Setbacks Front Back: X Right Side: Left Side:
3
DETAILED DESCRIPTION:t�FWORK
Install 1 accordion shutter
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CaNSTRUCTIQN:IN FORNt
aTION
Additionalwork to be Dertormed under tispermit–check all appy:
11HVAC Gas Tank Gas Piping _Shutters Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ 5,654.00 Utilities:Sewer Septic Building Height:
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OVI(N ER/LESSEE CONTRACTOR:
Name Billie A Brooks Name: Michael Heissenberg
Address:5051 N Highway Al#4-3 Company: Expert Shutter Services
City: Fort Pierce State:FL Address: 668 SW Whitmore Dr ;I
Zip Code: 34949 Fax: City: Port Saint Lucie State:FL
Phone No.772-577-4072 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.
SUPPLEMEIVTAL.GQNSTRUC`fION LIEN LAW I(UIwORMATION a
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Tiltecolna Name:
Address:6355 NW 36th St Suite 305 Address:
City: Virginia Gardens State: FL City: State:
Zip: 33166 Phone: Zip: Phone:
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FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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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 structu.je
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 jobsitel
before the first inspection. If you int nd to obtain financing, consult with lender or an attor ey before
commencin eqr n o Notice of Commencement.
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Signature of Owner/Lessee/Contractor a 09ent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA pp I� 1� STATE OF FLORIDA
COUNTY OF WlC I COUNTY OF
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Thefor oing instrume t was acknowledged before me The forgoing instrument was acknowledged fore me
this day of 20 2hby this n day of loin 20 by
Michael Heissenb&g Michael Hsissenberg
(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 I// OR Produced Identification I
Type of Identification Produced Type of Identification Produced 11
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jwy )Shanon O'Shea o� X. .
NOTARypUSL
eCommission No. Q� �; NOTARY PUBLIC Commission No w STATE Op FSO
STATE OF FLORI A �S�'vComm#G DA
a G25
8
5: 0 Aires 9/12/20 2
Revised 07/15/2014 INCE 14 Expires 9/12/2022
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW!
DATE
COMPLETE
INITIALS
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