HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
13
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
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Address: 9550 S OCEAN DR 1610
Legal Description: ISLANDIA I CONDOMINIUM UNIT 1610
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Property Tax ID#: 4502-601-0154-000-2 Lot No.
Site Plan Name: Block No.
Project Name: Hulsebus
Setbacks Front X Back: X Right Side: Left Side:
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Install 2 accordion shutters
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Acid itiona workto e e orme under t s permit—c ec all apply:
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Tank ❑Gas Piping Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 10,955.00 Utilities:Sewer Septic Building Height:
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Name Michael J Hulsebus Name: Michael Heissenberg
Address:9550 S OCEAN DR 1610 Company: Expert Shutter Services
City: Jensen Beach State:F� Address: 668 SW Whitmore Dr
Zip Code: 34957 Fax: City: Port Saint Lucie State:FIL
Phone No.815-520-2453 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: Tilteco lm. Name:
Address:6355 NW 36th St Suite 305 Address:
City: Virginia Gardens State: FL City: State:
Zip: 33166 Phone: Zip: Phone: I
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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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
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WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice fort
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/Lessee/Contractor as AV Or Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF St.Lucie CO U NTY OF St.Lucie
The f going instru cknowledged before me The forgoing instrument was acknowledged before me
this cS day of 20 aby this i_day of 20 by
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Michael Heissenb&g Michael Heissenberg
(Name of person acknowledging) (Name of person acknowledging)
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(Signature of Notary Public-State of Florida) (Signature of Notary ublic-State of Florida)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
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(� s �� for O'Brien
Commission No. � "l g'��RYq Commission No. UU Seal
�� � TARY PUBLIC � (
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r $Tt>�`i o STATE OF FLORIDA
NOTARY PUBLIC
Revised 07/15/2014
s'06E ieN Expires 2/17/2024 ESTATE OF FLORIDA
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEAW1TN17 WANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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COMPLETE
INITIALS
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