HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: p �l �1 Permit Number: �,a- �����
RECEIVED V1AR 03 2017
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
PR�POSED.IMPROUEMENT LOCATION
Address: 9500 S Ocean Dr#1108
Legal Description. ISLANDIA II CONDOMINIUM UNIT 1108
Property Tax ID#: 4502-602-0102-000-6 Lot No.
Site Plan Name: Stanley K Lynn Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
r x
DETAILED DESCR'IPTION'*-OF.WORK:
Install 1 Accordion Shutter
CONSTRUCTION INFORMATION
Additional work to e nertormed under this permit—check all apply:
11HVAC 1:1 Gas Tank ❑Gas Piping Shutters ❑Windows/Doors
11 Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction: $ 2939.00 Utilities:cn Sewer E]Septic Building Height: 180'
OWNER/LESSEE CONTRACTOR:
Name Stanley K Lynn Name: Michael Heissenberg
Address:9500 S Ocean Dr#1108 Company: Expert Shutters
City: Jensen Beach State:FL Address: 668 SW Whitmore
Zip Code: 34957 Fax: City: Port St Lucie State:FL
Phone No.706-490-7399 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 INFORMATION:'
:.t�
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _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 inspe tion. If you intend to obtain financing, consult with lender or an attorney before
commencing wor or repor-cling youAotice of Commencement.
s
_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF L/�ut C I t COUNTY OF 5' j�L'c CL
The forgoing instrument was acknowledged before me The f rjoing instrument was aIc-knowledged before me
thisft5� day of ►O1a.([-� 201 ) by thisdayof rn(� (C�VI 20 Eby
Michael Heissenb&g Michael Heissenberg
(Name of person acknowledging) (NAQe of person acknowledging)
(Signature of Notary Pu ic-State of F ) (Signature of Notary Pu c-State of Flo d )
Personally Known OR Produced Identification Personally Known Notary
Produced Identification
Type of Identification Produced Type of Identification Produced
17 ba6gpryA ASH +TFIER VIZZO Commission No. �yr,40.4>t���as H�jAS HcF: VIZZO
Commission Ns��gs� AS�Y PUBLIC :; ei�C3 i ARY PUBLIC
STATE OF FLORIDA
=
�? c(� ATE OF FLORIDA
Revised 07/15/2014 wo of� Expires 11/13/2018 NEti Ib Expires 11/13/2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS