HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED n 2
Date: Permit Number: 0?1
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
Address: 9500 S OCEAN DR 1307
Legal Description: ISLANDIA II CONDOMINIUM UNIT 1307
Property Tax ID #: 4502-602-0121-000-5
Site Plan Name:
Project Name: Galimo
Setbacks Front Back: X
Install 1 accordion shutter
Right Side: Left Side:
Lot No._
Block No.
HaurEionai worK to De errormea under this permit— check all apply: -
1]HVAC _ Gas Tank []Gas Piping 10 Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers E Generator 1:1 Roof Roof pitch .
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 3,637.00 Utilities:CnSewer Septic Building Height:
Name Judith Galimo & Nicholas LaBella
Address: 2507 Genesee St.
City: Utica State: NY
Zip Code: 13501 Fax:
Phone No. 315-796-8393
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: Michael Heissenberg
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
it value or construction is :>cbuu or more, a KtcoKDtD Notice of Commencement is required.
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DESIGNER/ENGINEER: _ Not Applicable
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MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
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.
01
Signature of Owner7Less6e/Contra Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDAj` �f I r i
COUNTY OF (i �l,
STATE OF FLORIDA N
COUNTY OF Q-_
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Swxn to (or affirmed) and subscribed before me of
X1 P ysical Pr ese ce r Online Notarization
this day of 202� by
Sworn to (or affirmed) and subscribed before me of
}�i Ph sical Pres e r Online Notarization
this Xday of 202p by
Name of person making statement.
Personally Known OR Produced Identification
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notaryu lic- State of Florida)
(Signature of Notary Public- State of Florida )
((��,, O'Brien
Commission No.U` a I
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UJ STTATE OF FLORIDA
p A �T�a��4r O'Brien
Commission No. sso�,�,'tT'ARY PUBLIC
° STATE OF FLORIDA
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