HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED e
Date: 313� �'' Permit Number: 1� 'Gjig
RECEI� -C
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 IMMOVEME'NT LOCATION;
Address: 5151 N A1A 811
Legal Description: OCEAN HARBOUR CONDOMINIUM A- UNIT 811
Property Tax ID#: 1411-705-0035-000-3 Lot No.
Site Plan Name: Alan D Henderson Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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DETAILED DESCRIPTION.DF"WORK: ..'
Install 1 Accordion Shutter
CONSTRUCTION INFORMATION
Additional work to be performed under this permit—check all apply:
�HVAC Gas Tank ❑Gas Piping �_Shutters Q Windows/Doors
Electric ❑_Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 6388.00 Utilities: _Sewer[]Septic Building Height: 80
OWNER/LESS'EE CONTRACTOR
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Name Alan D Henderson Name: Michael Heissenberg
Address:5151 N Al 811 Company: Expert Shutters
City: Fort Pierce State:FL. Address: 668 SW Whitmore
Zip Code: 34949 Fax: City: Port St Lucie State:FL
Phone No.772-464-7476 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFO(�MATION
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: walterTillit Name:
Address:6355 NW 36th St Address:
City: Virginia Gardens State: Ft_ 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 inspection. If you i nd to obtain financing, consult with lender or an attorne efore
commencing wor rpWding yor Notice of Commencement.
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_Signature of Owner/Lessee/Agent Signature of Contractor/License Holde
STATEFFLF FL
COUNTOY OF ORIDA �, L�U C I � COUNTSTATEOY OF ORIDA ] L U c /T
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this I day of m/�l ! (,L� 20 Lby this S� day of MCA✓ (_/1k 20 by
Michael HeissenbArg Michael Heissenberg
%merson acknowledging) (Name of person ack owledging)
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(Signature of Notary PybIic-State of My
r' (Signature of Notary70R
c-State of Flori
Personally Known �// OR Produced Identification Personally Known Produced Identification
Type of Identification Produced Type of Identification Produced
5ta'2Y�g HEATH r (( � SSkE'Y�g� R VIZLL)
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Commission No s�,Sga-ITARY PUBLIC Commission No. �1 LQ N _ir_ �I'OTARY PUBLIC
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« 1 STATE OF FLORIDA STATE OF FLORID
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s,,�'` Expires 11J13l2018 yc9�° Expires 11/13/201
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS