HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: E. \"1• Permit Number: aWS-O S 2 1
Building Permit Application a�
Planning and Development Services VI t
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982�2nt9
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residers M.
PERMIT APPLICATION FOR: Shutter
Address: 9500 S OCEAN DR 1702
Legal Description: ISLANDIA II CONDOMINIUM UNIT 1702
Property Tax ID #: 4502-602-0156-000-9
Site Plan Name:
Project Name: Batiwalla
Setbacks Front Back: X
Install 1 accordion shutter
E1HVAC Gas Tank
11 Electric 0 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 3,438.00
Right Side: Left Side:
Sprinklers 11 Generator
S Ft. of First Floor: _
Utilities:cn Sewer O Septic
Lot No._
Block No.
Windows/Doors
F]Roof Roof pitch
Building Height:
f . x..
-
uffi �
Name Derick Batiwalla
Name: Michael Heissenberg
Address: 9500 S OCEAN DR 1702
Company: Expert Shutter Services
City: Jensen Beach State: FL.
Address: 668 SW Whitmore Dr
City: Port Saint Lucie State: FL
Zip Code: 34957 Fax:
Phone No.901-737-2929
Zip Code: 34984 Fax: 772-871-0990
E-Mail:
Phone No. 772-871-1915
E-Mail: Callexpert@aol.com
Fill in fee simple Title Holder on next page ( if different
State or County License: 16572
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not App
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
Citv:
Zip: Phone:_
Not Applicable
State:
BONDING COMPANY: Not Applicable
Name:_
Address:
City:_
Zip:
Phone:
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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County 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.
Signature of Contractor/License Hol r
Signature of Owner/ Lessee/Contrac as Agent for Owner
STATE OF FLORIDA �.{pn�
�IZ,
STATE OF FLORIDA ,( c
COUNTY OF
COUNTY OF ( r LA�
Sw"n to (or affirmed) and subscribed before me of
i' P ysical Presence or Online Notarization
Swqyy to (or affirmed) and subscribed before me of
sical Prese a or Online N tarization
this day of 0ML 202k by
ihipm day of 202@ by
Name of person making statement.
Name of person making statement.
r
Personally Known OR Produced Identification
Personally Known _ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
�1
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
/) ONRygs Taylor O'Brien
Commission No. U' Q OTARY�°U
('�(/�, S�Rpq Taylor O'Brien
Commission No. V vvU�� �� 1POTARYPUBLIC
MAIM
ESTATE OF FLORID
o STATE OF FLORI
aC
i
`NCE 19�� E
Aires 2/17/202
S�N L9��
EEXX I es 2/17/20
WNGROVE
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATUR�t
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20