HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
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
PROPOSED IMPROVEMENT LOCATION:
Address: 7370 S OCEAN DR 413 JENSEN BEACH, FL 34957
Legal Description: DUNE WALK BY THE OCEAN a/k/a SAND DOLLAR NORTH BLDG B UNIT 413
Property Tax ID #: 3522-607-0075-000-1
Site Plan Name:
Project Name: Lewis
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Install 1 accordion shutter
Lot No.
Block No.
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit — check a apply:
E1HVAC Gas Tank Gas Piping Shutters Q Windows/Doors
11 Electric Plumbing Sprinklers ElGenerator a Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 2,071.00
Sq. Ft, of First Floor:
Utilities: F]Sewer 0Septic Building Height:
OWNERAESSE€:
CONTRACTOR:
Name William & Jill Lewis
Name: Michael Heissenberg
Address: 29 Puddingstone Ln
Company: Expert Shutter Services
City: Millington State: NJ
Zip Code: 07946 Fax:
Phone No. 908-625-9426
Address: 668 SW Whitmore Dr
City: Port Saint Lucie State: FL
Zip Code: 34984 Fax: 772-871-0990
Phone No. 772-871-1915
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: Callexpert@aol.com
State or County License: 16572
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAIN INIrOR _, MTIOW `
z ,
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: _
Address:
City: _
Zip:
Phone:
Name: _
Address:
City:_
Zip: _
I certify that no work or installation has commenced prior to the issuance of a permit.
Phone:
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 wor rgrec rdinp, vourAotice of Commencement. �� _ 9
as ARer1rTor Uwner I Signature oT contractor/uo"se
STATE OF FLORIDA
COUNTY OF St. L=ie
The f r oing instrument was acknowledged, Pefore me
this day of r i 20 �Lby
Michael Heissenberg
(Name of person acknowledging )
qQ\�
(Signature of Notary Public- State of Florida )
Personally Known X OR Produced Identification
Type of Identification Produced
Commission No. 6� l NOTARY PUBLIC
STATE OF FLORID
Cowin* GG9589N
" Expires 2/17/2024
Revised 07/15/2014
STATE OF FLORIDA
CO U NTY OF St. L.ae
The forgoing instruRf
t was acknowledged before me
this -LYE day of ( � , 20 L7U by
Michael Heissenberg
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known x OR Produced Identification
Type of Identification
(�Produced
(�
Commission No. 1 `-Igwqq C16 Taylor O'Brien
NOTARY PUBLIC
STATE OF FLORil
'- rtW rw GG9589%
Expires 2/17i2=
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS