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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date : Permit Number :
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............ ... . . ... ... ..... ....
u il di ng Permit A p plication
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
R �t�3PC�SE-D'- .1 ftl1 � RQ1lE MENT LC?CATf � N :
Address : 10200 S OCEAN DR PH -4
Legal Description : ATLANTIS III BY THE SEA UNIT PH4 ( 704 ) AND PRO - RATA SHARE IN COMMONELEMENTS
Property Tax ID # : 4511 - 518-0062-000-3 Lot No ,.
Site Plan Name : Block No .
Project Name : Bevis
Setbacks Front X Back : X Right Side : Left. Side :
C , 1 ,P
I ? y I :.
F W 0-R.K
OIL' .
Install 4 accordion shutters
Ct��1STF€ C1CTlON I 'N FQRMATIt� N :
-Additionarwork tobe ertormedunder this permit — check a a pp y :
HVAC _ Gas Tank Gas Piping � Shutters � Windows / Doors
Electric Plumbing Sprinklers � Generator � Roof � Roof pitch
Total Sq . Ft of Construction : S F t . of First Floor -:
Cost of Construction : $ 3 .0164400 Util it ies : Sewe r � Septic BUllding Height :
V-W-N---E' R�� R TO
Name Ricky A Bevis & Antonio N Arroyo Name : Michael Heissenberg
Address : 1621 Lugo Ave It Expert Shutter Services
C,1 t y : Coral Gables State : F� Addres s : 668 SW Whitmore Dr
Zip Code : 33156 Fax : _ _ City : Port Saint Lucie State : FL
W,
Phone No . 305*o794.w9410 Zip Code : 34984 Fax : 772 -871 -0990
E - Mails Phone No ,. . 772- 871 - 1915
Fill in fee simple Title Holder on next page ( if different I'_. - 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 .
S-- T-.' �'UCTIt�� LI �� tAVlJ IN.Ft3f� MAT10 ( L_
DESIGN ER/ ENGINEER . T Not Applicable MORTGAGE COMPANY : x Not Applicable
Name ',: Tilteco inc .
Name ,
Address : 6355 NW 36th St Suite 305 Address :
City * Virginia Gardens 4P awdm%� St2t2 : F� City * Statel,
ZJp6 33166 Phone : Zip : Phone :
FEE SIMPLE TITLE HOLDER : x Not Applicable BONDING COMPANY : _Not Applicable
N ame : Name .
Address : Address :
City : City :
Zip : Phone : Zip : Phone :
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 appl ications 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 jo :bsite
before the first inspection . If you intend t obtain financing, consult with lender or an attorn before
commencinRwork o our No ' e of Commencement .
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Signature of Own er/Lessee/Con tractor as Agent r Owner Signature of Contract-or/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF <S� � �. COUNTY OF
T h e farRo'l ng i n str e was ac n wledge before me The forgoing instrument was acknowledged before me
this �'� day of � ✓ 20 by this day of ► q � . � �,� , 20 by
Michael Heissenb&rg Michael Hsissenberg
( Name of person acknowledging ) ( Name of per 'son acknowledging )
(Signature of Notary Publics" State of Florida ) ( Signature of NotaryPublic- State of Florida )
Personally Known T OR Produced Identification Personally Known JV OR Produced Identification
Type of Identification Produced Type of Id entif i cation�uced
Commission No. 5S�A Y al O'Brien Commission No . AL ( Sea l )
qr � OTARY PUBLIC Y 4& Taylor O'Brien
ESTATE OF FLORIDAmmmmmmmh� � s�� NOTARY PUB
LIC
0" � ? Comm# GG958999 � STATE OF FLORIDA
Revised 07/ 15 /2014 space �9�� Expires 2/ 17/2024 `': �`� C, Comm# GG958999
iir M9117-12n2d
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