HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED b3
Date: Permit Number: 1RMMD
Oki b V.1021
• � III .
Building Permit Application �t.I_ubteCb�ritY
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
1 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMIT APPLICATION_ FOR: Shutter
Address: 9650 S OCEAN DR 701
Legal Description: THE PRINCESS OF HUTCHINSON ISLAND UNIT 701
Property Tax ID #: 4502-610-0061-000-1
Site Plan Name:
Project Name: Combs
Setbacks Front X _
Install 3 accordion shutters
Back: X Right Side: Left Side:
Lot No.
Block No.
Additional work to bjenertormea unaer tnis permit— cnecK aii apply:
F]HVAC ID Gas Tank ❑Gas Piping Shutters E]Windows/Doors
Electric ElPlumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 10,396.00 Utilities:Sewer U Septic Building Height: _
Name Katherine Combs
Address: 5217 Cassandra Ln
City: San Diego State: CA
Zip Code: 34957 Fax:
Phone No.734-671-2215
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: Michael Heissenberg
Roof pitch
Company: Expert Shutter Services
Address: 668 SW Whitmore Dr
City: Port Saint Lucie State. FL
Zip Code: 34984 Fax: 772-871-0990
Phone No. 772-871-1915
E-Mail: Callexpert@aol.com
State or County License: 16572
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER:
Name:_
Address:
City:
Zip:
Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:_
Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
State:
Not Applicable
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 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 attornev before commencing work or recording vour Notice of Commencement.
Z
Signature of Owner Lessee/Contractor gent for Owner
Signature of Contractor/License Hol
STATE OF FLSTATE
OF FL
6) k n;l,p
COUNTY OFORIDA (�I, U v
COUNTY OFORIDA.
SW o to (or affirmed) and subscribed before me of
hysical Prese e r Online Notarization
Sworn to (or affirmed) and subscribed before me of
P sical Presen e o Online Notarization
this day of 202t by
this day of 202(1 by
` P
MN I
,1lotl
Name of person making statement.
Name of person making statement.
Personally Known 01— OR Produced Identification
Personally Known'O OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- to of Florida )
Commission No. Assn (NOTARYQUBLIC
JpRYA Taylor O'Brien
Commission No. QO'Brien�� �ikbTARYQUBLIC
oQ ESTATE OF FLORIDA
QJ o STATE OF FLORID
REVIEWS
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DATE
RECEIVED
DATE
COMPLETED
Rev.5/6/20