HomeMy WebLinkAboutBuilding permit appAll 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 Residential X
PERMIT TYPE: Shutter
PROPOSED IMPROVEMENT LOCATION:
Address: 5918 Walnut Park Ln.
Property Tax ID #. 1312-502-0022-000-2
Site Plan Name:
Project Name: Kiyashko
DETAILED DESCRIPTION OF WORK:
Install 4 accordion shutters
CONSTRUCTION INFORMATION;
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank _ Gas Piping X Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cost of Construction: $ 2,664.00 Utilities: _ Sewer _ Septic
Lot No._
Block No.
Windows/Doors
Roof Pitch
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Gennadiy Kiyashko
Name: Michael Heissenberg
Address: 5918 Walnut Park Ln.
Company: Expert Shutter Services
City: Fort Pierce State: FL
Zip Code: 34951 Fax:
Phone No. 312-882-4685
Address: 668 SW Whitmore Dr
City: Port St. Lucie State: FL
Zip Code: 34984 Fax:
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 Permits@expertshutters.com
State or County License 16572
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:
- k I
DESIGNER/ENGINEER, _ N1i('.��I bie MORTGAGE COMPANY: Not Applicable Name:
Name: nitea) inc.Ww.._
Address: 6355 NW 36th $I Suite 305 Address:
City:yirgirim Gardens State: FL City: Mate:
Zip: i3Ya Phone _ Zip:.__ _ Phone:
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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
in
which is conflict with any applicable Nome Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Nome 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 Codas 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 TH , FIRST INSPECTION. IF YOU INTENT) TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER A.1TORNEYeEFORE RECORDING YOUR NOTICE OF COM MENT ,
Signature of Owner/ Lessee/Contractor as Agent f r Owner Signature of contractor/License Holder
a
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF , t-tkoS(- COUNTY OF S lwta C'
The forgoing instruin it was acknowledged before me The for Ding instrumen was acknowledged before me
this � day of 26& by
_ , this , _ day of 20Z_ by
Name of person making statement. Name of person making statement.
Personally Known _._.. OR Produced Identification Personally Known ri�
_ OR Produced Identification
Type of Identification —
Type of Identification 4
Produced_ Produced
i
___,_,__...__._.
i � r
(Signature of Notary Public4of� NOiA1�Y pUBt,4C (Signature of Notary Pu lie- State o*FloirJ* harron a'Stiba
Commission No.TRTC OF FtOt G. tJTARY i?ilE3LlComm#C3G258t138 Commission No. ��1 �TAiE OF FLOR DD2
omm# GG2580 8
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
_. _.._.
DATE
REC€IVED
DATE
COMPLETED 1
G
EXPERT
SHUTTER SERVICES INC.
're raking The Shatter industry By Stwm-
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F lVE YEAR WARRANTY FOR PARTS ANb LABOR. QUOTES AtRIZ VALID FOR 30 DAY&
SHUTTERS MUST 131E MAINTAINED PROPERLY (SEE MAINTENANCE INFORMATION,,.
Cats me: 586-393- 6 Email: c;ameramg�xpertshutters.com
868 S.W. WHITMORE DR.
PORT ST. LUCIE, FL 34984
(772) 871-1918 (800) 749-9056
FAX (772) 871-0990
i``'"'rCAA ERON GRtBBS ��