HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 11
Date: Permit Number: o�
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
PRUPOSEQ lIt11P9QVEMENT LC}CATI+DNffiM
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Address: 10310 S Ocean DR Apt 704
Legal Description: OCEANRISE CONDOMINIUM APT 704 AND UNDIV SHARE IN COMMON ELEMENTS
Property Tax ID#: 4511-515-0062-000-4 Lot No.
Site Plan Name: Block No.
Project Name: Dziama
Setbacks Front Back: X Right Side: Left Side:
3" 1 `gr --,r' ✓ ( ssr- are v ryyPr ,iet3` .1: s'Fka'r' Fes '
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iAI�EQ DESCRIPTION FW7RK _4 r ��
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Install 1 accordion shutter
�CC�NSTRUCTIO1 INF4RMATlON �
Additional work to e e orme under this permit-checka apply:
11HVAC Ei Gas Tank Gas Piping MGenerator
Shutters Windows Doors
Electric ❑ Plumbing Sprinklers Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 1,722.00 Utilities: Sewer Septic Building Height:
/ + x; ,,,p. l"*��, r'3 P' �<.t CQNTR�C 'C)R r
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C11tklNER LESSEE 1
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Name Pauline Dziama Name: Michael Heissenberg
Address:10310 S Ocean DR Apt 704 Company: Expert Shutter Services
City: Jensen Beach State:FL Address: 668 SW Whitmore Dr
Zip Code: 34957 Fax: City: Port Saint Lucie State:FL
Phone No.404-431-3912 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.
SL�P,PLEMENTAL CONSTRUCTIQN LIB pLA111l�INf ?R,MATION '
�... ,.a:.',.
DESIGNER/ENGINEER:
........ ....
Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Tiltecolnc. Name:
Address:6355 NW 36th St Suite 305 Address:
City: Virginia Gardens State: F!_ 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 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 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&see Contractor as nt for Owner Signature of Con ractor/License H er
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF St.Lucie COUNTY OF St.Lucie
The f going instru n s cknowledged before me The orgoing instrument was acknowledged before me
this day of C 20 J�by this day of c��1,n`�C. 20' by
Michael Heissenlrg Michael Heissenberg
(Name of person acknowledging) (Name of person acknowledging)
U - I�A
(Signature of Notary Public-State of Florida) (Signature o otary Public-State of Florida)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
RYa v
T ytor O'Brien
Commission No. CC O'Brien Commission No. e� ARY PUBLIC
0 NOTARY PUBLIC ,—�� a
_STATE OF FLORIDA
Revised 07/15/2014 Comm#GG958999446E 19l'c Expires 2/17/2024
Expires 2/17/2024
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS