HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED !n x
Date:41 JiG
Permit Number:
w..
Building Permit Applicatiorkr�jr�✓'�'2��Q?
Planning and Development Services SC ��g
Building and Code Regulation Division
Virginia Avenue,
2300 Vir9 Fo rt Pierce FL 34982 cap'h�P�t
Phone: (772)462-1553 Fax: (772)462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Shutter
PROPOS.E,D IM'PRUVEMENT LOCATIQN
Address: 5047 N Highway A1A 1404
Legal Description: ATLANTIC VIEW BEACH CLUB CONDOMINIUM#1 UNIT 1404
Property Tax ID#: 1414-610-0070-000-8 Lot No.
Site Plan Name: Block No.
Project Name: Judy
Setbacks Front Back: X Right Side: Left Side: X
DETAILED`DESCRIPTION-OF4WOR1< 3x
Install 3 accordion shutters
_.
CONSTRUCTIOW]N FORM0101\11—
Additwnnal work to e e orme under tispermit—check a appy:
HVAC Ei Gas Tank
—]Gas Piping Shutters Q Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 11,479.00 Utilitiescn Sewer E]Septic Building Height:
I
01NNER LESSEE CONTRACTOR
r
Name Kenneth W Judy Name: Michael Heissenberg
Address:268 Mooney Hill Rd Company: Expert Shutter Services
City: Patterson State:NY Address: 668 SW Whitmore Dr
Zip Code: 12563 Fax: City: Port Saint Lucie State:FL
Phone No.845-878-3621 Zip Coder 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.
� I
i
SUPPLEMENT, CQNSTkOCTICIN LIE
„ .
N LAW INF{ RMATION
...
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Tiltecolnc. 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 attorney before
commencing work orre ording your/Wotice of Commencement.
s
Signatu o Owner/Le ee Con ct as Ag t for Owner Signitupel6f Contractor/License Hol er
'N/V
STATE OF FLORID r I UI STATE OF FLORIDA �(
COUNTY OF � W COUNTY OF d-� 1 1 u
The for oing instrume t was acknowledged before me The forgoing instrument was acknowledged before me
this L) day of20—&by this day of t`-1 20 Z� by
Michael Heissenb6rg 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 V OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No �?03� (Seal) Commission No 1X�)O DJ� (Seal)
�ptARYASillZZOZ/Z6/6 sEWUR=101,
NOTARY PUBLIC
Revised 07/15/2014 8£ 85ZJJ#wwo0 r �'
a +STATE OF FLORIDAA
o `d41801d d0 31d1S a g
Ws g 011end AUV10 o�
REVIEWS FRONT ZONINGU` ERS I� 9/�`Z/ Rl VEGETATION SE%P4WTTV1e4MA&VOVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS