HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application Aauno:)aionj •4S
Planning and Development Services auawJJedaa 6u14wJad
Building and Code Regulation Division d101 atl�
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax:J772)462-1578 Commercial X Residential
03AI303a
PERMIT APPLICATION FOR: Shutter
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Address: 9650 S Ocean Drive#1907
Legal Description: THE PRINCESS OF HUTCHINSON ISLAND UNIT 1907
p y 4502-610-O'177-000-7
Pro ert Tax ID#: Lot No.
Site Plan Name: Rasmussen Block No.
Project Name: Rasmussen
Setbacks Front Back: Right Side: Left Side:
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AFTER THE FACT ; Installed 2 Accordion Shutters
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rtiona wor to e e orme un er t is permit—c eck a apply:
�HVAC Gas Tank Gas Piping V(_Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers ❑Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 696.00 Utilities:Sewer Septic Building Height:
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Name Philip A Rasmussen&Cynthia A Rasmussen Name: Michael Heissenberg
Address:43 Quarry Rd Company: Expert Shutter Services
City: Port Ludlow State:WA Address: 668 SW Whitmore Dr
Zip Code: 98365 Fax: City: Port Saint Lucie State:FL
Phone No.360-437-0648 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: Permits@expertshutters.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 LAIN INFORMATIO( Y
8
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Tiltecolnc. 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.
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 approvedl 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
commencing work or recording our Notice of Commencement.
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Signature of Owner/L ssee/Contractor a ent for Owner Signature of Contractor License Hol
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF St.Lucie COUNTY OF St.Lucie
The oing instr nt s acknowledgedbefore me The for oing instrument,w acknowledged before me
this day of 20 ((_//\\by thi day of� GM 20—a by
Michael Heissenb&g Michael Heissenberg
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of No Public-State of Florida)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. GG958999 �yAss' ��I�()O'Brien Commission No. GG95s999 o�p I�Taylor O'Brien
o OTARY PUBLIC �' �, NOTARY PUBLIC
oars ESTATE OF FLORIDA9+STATE OF FLORID
Y a Comm#GG9589 y om8999,
Revised 07/15/2014 Ns�lce Ae�'g Expires 2/17/2024 S%vice l9n° Expires 2/17/202
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS