HomeMy WebLinkAboutApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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 Residential X
PERMIT TYPE: Shutter
Address: 7028 Willow Pine Way
Property Tax ID #.. 3322-621-0052-000-4
Site Plan Name:
Project Name: Malaska
DETAILED DESCRIPTION OF WORK:
Install 3 accordion shutters
CONSTRUCTION INFORMATION.
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank _ Gas Piping X Shutters
Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cost of Construction: $ 2,775.00 Utilities: —Sewer _Septic
Lot No._
Block No.
Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name George J Malaska
Name: Michael Heissenberg
Address: 7028 Willow Pine Way
Company: Expert Shutter Services
City: Port St Lucie State: FL
Zip Code: 34986 Fax:
Phone No. 216-374-2531
Address: 668 SW Whitmore Dr
City: Port St. Lucie State: FL
Zip Code: 34984 Fax:
Phone No 772-871-1915
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail Permits@expertshutters.com
State or County License 16572
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL
INEER
ON LIFN LAW INFORMATION:
— Not Applicable
Name: Tilteou i-
Address: 6355 NW 36th St Suite 305
City. Virginia Gardens State: FL
zip: a'31t,6 . Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:_
MORTGAGE COMPANY: Not Applicable
Name,
Address:
City: --- State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WffH Yntin i FiunFD na,4ou AyTriinvury rcnn
Signature of owner/ Lessee/Contractor as Agent f r Owner
..........
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF L resit
COUNTY OF �,t
The forgoing instrument was acknowledged before me
this 16 day of March 2o"121
The forgoing instrument was acknowledged before
March
me
by
this 16 — day of __ 2o 21 by
Michael Heissenberg
Michael Heissenberg
Name of person making statement.
Name of per -sot) making statement,
Personally Known _Z__ OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
Pub""
f a' 'o' ate Notary
(Signature of Notary Public- State 0 a 0fp'R�f PUBLIC
7s—i
gnatu re of Notary Public- State of Flo
Sharion O'Shea
Commission No. GG258038 s ATE OF FLORIOX
G 258038 *�;.T
GG2W36
GG258038
Commission No. e
NOTARY PUBLIC
r
commo
TATE OF FLOR
res
commilli GG25803f
2
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
PLANS VEGETATION SEA TURTLE
MANGROVE
�X�
REVIEW REVIEW REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev7277T1_9—