HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: W (0
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
FIR POSED 111 PROVEMENTL{?CAT1 1tN . .; �c , . *�_ �_ .._.
Address: 9500 S Ocean DR Apt 401
Legal Description: ISLANDIA II CONDOMINIUM UNIT 401
Property Tax ID#: 4502-602-0025-000-2 Lot No.
Site Plan Name: Block No.
Project Name: Donaghy
Setbacks Front X Back: Right Side: Left Side:
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D "CAILED IPTIQNE WORK• r �$q YP , � 3
.ass
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Install 1 accordion shutter
CQNSTRUCTIN INFORNfAT)QNRON
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Additional work to be nertormed under this permit-check all apply:
❑HVAC Gas Tank Shutters .
❑Gas Piping ❑Wind w o s/Doors
- ❑Electric ❑ Plumbing []Sprinklers ❑Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 1,567.00 Utilities:Cn Sewer❑Septic Building Height:
�UUNER/I.ESSE CQNTRACT(ll � TA
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Name Liseta C Donaghy Name: Michael Heissenberg
Address:9500 S Ocean DR Apt 401 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.772-446-4242 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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SUP,PLEMENTAL CONSTRCJCTIC)N LIECI CAINCNF; CtM�ATIO zom
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Tiltecoinc. 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:
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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
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 Twner/resseelContract074
ent for Owner Signature of Contractor/License H9 er
STATE OF FLORIDA STATE OF FLORIDA
CO U NTY OF St.Lucie COUNTY OF St.Lucie
The f going instrumen w s acknowledge before me The orgoing instrument wa�s,��yyacknowled ed before me
this la day of 20 k by this day of J�n`G 20 by
Michael Heissenberg Michael Heissenberg
(Name of person acknowledging) (Name of person acknowledging)
' W) 92)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
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Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Tlui O'Brienype of Identification Produced
RYgo TRY PUBLIC �othergsso RY PUBLIC
Commission No. I��`` Commission No
M-4STA7E OF FLORIDA 3 ,� E OF FLORIDA
`e Comm#GG958999 ?Comm#GG958999
7yCE M Expires 2/1 CE tie Expires
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS