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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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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
RtPDS' DEt1R011EM1T
Address: 7440 S OCEAN DR 325
Legal Description: SAND DOLLAR VILLAS CONDOMINIUM A-UNIT 325 AND UND PRO-RATA SHAREIN COMMON ELEMENTS
roperty Tax ID#: 3522-602-0010-000-3 Lot No.
Site Plan Name: Block No.
Project Name: Bagshaw
(Setbacks Front X Back: X Right Side: Left Side:
DETAILED DESCRIPTION Q WORK
Install 1 roll & 2 accordion shutters
CQ TRUCTI INFORMATIO(U r F . 4 £ x, F ,
r
Additional work to e e orme under this permit—check a_ apply:
1]HVAC E]Gas Tank Gas Piping Shutters Q Windows/Doors
11 Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 2,679.00 Utilities:cnSewer OSeptic Building Height:
OUtfNER/LESSEE*3` CONTRACTOR; `
«. . . .�. ..., .
Name William D&Brenda Bagshaw Jr Name: Michael Heissenberg
Address:7440 S OCEAN DR 325 Company: Expert Shutter Services
City: Jensen Beach State:FL. Address: 668 SW Whitmore Dr
Zip Code: 34957 Fax: City: Port Saint Lucie State:FL
Phone No.860-670-0846 Zip Code: 34984 Fax: 772-871-0990
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.
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DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Tiltecclnc. Name: .
Address:6355 NW 36th St Suite 305 Address:
City: Virginia Gardens State: FL City: State:
Zip: 33166 Phone: 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.
IIn consideration of the granting of this requested permit, I do hereby agree that I will,in all respects,perform the work
Iin 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 intend to obtain financing, consult with lender or an attorney before
icommencing work or recording our Notice of Commencement.
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Signature of Owner/Lessee/Contractor as t for Owner Signature of Contractor/License Holde
STATE OF FLORIDA STATE OF FLORIDA
COUNTY O F St.Lucie COUNTY O F St.Lucie
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of ti 20�by this � day of' 20 3L by
Michael Heissenb&g Michael Heissenberg
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Taylor O'Brien �� Taylor O'Brien
Commission No. GGs56sss NOTARY PUBLIC Commission No. GGg56sss `� 5{@@ARY PUBLIC
SSTATE OF FLORI A STATE OF FLORIDA
Revised 07/15/2014 •lni te�b Expires 2/17/2024 Expires 2/17/2024
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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