HomeMy WebLinkAboutBUILDING PERMIT APPLICATION ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED —1 Date: Permit Number: D � •11� l h y
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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
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Address: 3150 N HIGHWAY A1A 1503
Legal Description: TIARA TOWERS UNIT 1503-N
Property Tax ID#: 1425-610-0071-000-9 Lot No.
Site Plan Name: Block No.
Project Name: Fairclough
Setbacks Front Back: X Right Side: Left Side:
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Install 3 accordion shutter
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Additionalwork to be performed un er t� ispermit—check a apply:
. 0 Gas'Tank F_]Gas Piping Shutters
�HVAC Q Windows/Doors
Electric 0 Plumbing Sprinklers E]Generator E] Roof Roof pitch
;Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 6,986.00 Utilities:0Sewer 0Septic Building Height:
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Q1 NER/L 5S E r 9hny rF CC3NTRACT R � 011
Name Robert Fairclough Name: Michael Heissenberg
Address:3150 N HIGHWAY A1A 1503 Company: Expert Shutter Services
City: Hutchinson Island State:FL Address: 668 SW Whitmore Dr
Zip Code: 34949 Fax: City: Port Saint Lucie State:FL
Phone No.845-34-9200 Zip Code: 34984 Fax: 772-871-0990 M
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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SUPPLEMI� NT ONSIRUCT�OM50, L1�� INQR AT10> �
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Tilteco Inc. 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:
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.
s
Signature of Owner Lessee/Contracto Agent for Owner 3igrikure of Contractor/License er
,STATE OF FLORIDA STATE OF FLORIDA
,COUNTY OF St.Lucie COUNTY OF St.Lucie
'The ing instrument was acknowledged before me The forgoing instrument was acknowledged before me
�Tday
this of 203by this day of 20 by
Michael Heissenb,4g Michael Heissenberg
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
,Type of Identific tion Produced, Type of Identification Produced
Commission N QSM R(Seal) Shanon O'Shea Commission No Seal)
�°�P A& NOTARY PUBLIC ,MR qss Shanon O'Shea
Q ORI A aQ °�NOTARY PUBLIC
y =Comm s#GG258038FLORIDA
Revised 07/15/2014 =Comm#GG258038
S;NCE IS Expires 9/12/2022 s�NCE 19�� Expires 9/12/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS