HomeMy WebLinkAboutBuilding Permit Application (2) oD,;?1)
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit
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MAY 10" 20 0
Building Permit Application
Planning and Development Services
Building and Code Regulation Division C �^
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential XX
PERMIT TYPE:
.PROPOSE D'IMPROVE MENT LOCATION W21
Address: 6401 S Indian River Dr
Property Tax ID#: 3412-123-0001-000-9 Lot No.
Site Plan Name: Heizler Block No.
Project Name: Heizler
`DETAILED DESCRIPTION OF WORK: �' l
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ Utilities: —Sewer —Septic Building Height:
,OWNER/LESSEE: �. CONTRACTOR: -
Name Terry&Karen Heizler Name:Edward J Heritage
Address:6401 S Indian River Dr Company:Folding Shutter Corporation
City: Fort Pierce State:_ Address:1862 Dr Martin'Luther King Blvd
Zip Code: 34982 Fax:nia City: West Palm Beach State:FI
Phone No.772-233-7059 Zip Code: 33404 Fax: 561-640-8204
E-Mail:n/a 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.
If value of HVAC is$7,500 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:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Own essee/Cont—ractor as Agent for Owner Signature of Co or der
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF PALM BEACH COUNTY OF PALM BEACH
Thefor oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20;?C) by this—T day ofUN�1 20 K by
EDWARD J HERITAGE EDWARD J HERITAGE
Name of person making statement. Name of person making statement.
Personally Known — OR Produced Identification Personally Known — OR Produced Identification
Type of Identification Type of Identification
Prody-1=1 Produced
(Signature of Notary Pub�&RAS to gd8vans (Signature of Notary Public-State of Florida)
NOTARY PUBLIC
c� �,� ZpRygs Pamela A.Evans
Commission No. _STAT � LORIDA so
E{ h Commissia NOTA PUBLIC (Seal)
;. =Comm#GG262789 o STATE OF FLORIDA
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REVIEWS FRONT ZONING SUPERVISOR PLANS •sV9b TATFdofe �WdV E MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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