HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
RECEIVE 'AAR 0 3 W7
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 MATION
Address: 5055 N Al A#601
Legal Description: BRYN MAWR OCEAN TOWERS BUILDING C UNIT 601
Property Tax ID#: 1414-601-0133-000-0 Lot No.
Site Plan Name: Arthur Curcillo Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
`DETAILED DESCRIPTION OF WORK
Install 1 Accordion Shutter
CONSTRUCTION.INFORMATION
Additional work to a er orme under this permit-check a apply:
E]HVAC []Gas Tank ❑Gas Piping Shutters ❑Windows/Doors
❑Electric ❑ Plumbing Sprinklers ❑Generator ❑ Roof
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 1097.00 Utilities:cn Sewer[]Septic Building Height: 80'
OWNfR%LESSEE CONTRACTOR:
Name Arthur Curcillo Name: Michael Heissenberg
Address:5055 N Al #601 Company: Expert Shutters
City: Fort Pierce State:FL. Address: 668 SW Whitmore
Zip Code: 34949 Fax: City: Port St Lucie State: FL
Phone No.772-595-0552 Zip Code: 34984 Fax:
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.
SUOPLEMENTAL CONSTRUCTION LIEwN LAW INF(?RMATION::
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: XX Not Applicable
Name: WalterTillit Name:
Address:6355 NW 36th St Address:
City: Virginia Gardens State: FL City: State:
Zip: 33168 Phone: 305-871-1530 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 inspectioo4f you intend to obtain financing, consult with lender or an attorney before
commencing work or p6corOing your Diotice of Commencement.
s
_Signature of Owner/Lessee/Agent Signature of Contra ctor/Lic nse Holdef
STATE OF FLORIDA 5f—)_ L / , STATE OF FLORIDAt / I 'COUNTY OF - 1COUNTY OF _ [ �lACl
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this I day of Y��L�(;%, 20 _ Eby this L� day of �nO(C�l 20 _L:?by
Michael Heissenberg Michael Heissenberg
(Name of person acknowledging) (Na a of person acknowledging)
(Signature of Notary Pu lic-State of Florid ) (Signature of Notary`Pub is State of Florida)
Personally Known OR Produced Identification Personally Known OR OR Produced Identification
Type of Identification Produced Type of Identification Produced
t0.`�Y HEATHER VIZZO ,y�paYq HEATHER VIZZ
Commission N - 7 � �� �NOTARY PUBLIC Commission No. �R� (p lkl NO 'ARY PUBLIC
^,TE OF FLORIDA t, '[ STATE OF FLOR!
sr
Revised 07/15/2014 Expires 11/13/2018 �er Expires 11/13/20 8
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS