HomeMy WebLinkAboutBUILDING PERMIT APPLICATION ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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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: 9650 S OCEAN DR 403
Legal Description: THE PRINCESS OF HUTCHINSON ISLAND UNIT 403
Property Tax ID#: 4502-610-0033-000-6 Lot No.
Site Plan Name: Block No.
Project Name: Trociuk
Setbacks Front Back: X Right Side: Left Side:
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Install 1 accordion shutter
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Additional work to bnrtormed un ert ispermit-check a appy:
EIHVAC Gas,Tank Gas Piping Shutters Q Windows/Doors
Electric ❑ Plumbing Sprinklers In Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 4,602.00 Utilities:cn Sewer Septic Building Height:
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Name Michael E Trociuk Name: Michael Heissenberg
Address:554 Bretts Way Company: Expert Shutter Services
City: Whitesboro State:NY Address: 668 SW Whitmore Dr
Zip Code: 13492 Fax: City: Port Saint Lucie State:FL
Phone No.315-794-5527 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.
�5PPL)`lVIENTAL CO.NS,�R;t� �I®N Ll � L�1NIN�CII�MA1`I®� � `��
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Tilteco Ino. Name:
Address:6365 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.
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Signature of Owner/Less e/Contra ct V119ent for Owner Signature of Contractor/License Ho r
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF St.Lucie COUNTY OF Sc.Lucie
The forgoing instr ment was acknowledged before me The forgoing instrume t was acknowledged before me
this "7 day of 20C�(__by this day of < 20�by
Michael Heissen4g 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 Identification Produced Type of Identification Produced
Shanon O'Shea (Seal)
Commission No. otAR Commission No.
aQ NOTARY PUBLIC
o .-STATE OF FLORI A �aptARYAs Sfiano
Y Comm#GG258038 o g N07-ARY PUBLIC
Revised 07/15/2014 r�NCE 19�� Expires 9/12/2022 ao STATE OF FLO' to
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE M/�NG�
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW '
DATE
COMPLETE
INITIALS
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