HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
P p' y _. _.... __----
Building Permit Application AUG 30 2021
Planning and Development Services
Building and Code Regulation Division ST, Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
Address: 4200 N HIGHWAY A
Legal Description: OCEAN HARBOR SOUTH BLDG B UNIT 215 AND UND INTEREST IN COMMON ELEMENTS
Property Tax ID #: 1423-501-0111-000-1
Site Plan Name:
Project Name: Jefferson
Setbacks Front Back: X
Install 1 accordion shutter
Right Side: Left Side:
Lot No.
Block No.
iAciumonaiworKTODenerrormedunder this permit— check a apply: -
�HVAC _Gas Tank —]Gas Piping �_ Shutters Windows/Doors
11 Electric 0 Plumbing Sprinklers I Generator 0 Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 2,427.00 Utilities:i Sewer O Septic Building Height:
Name Marion Jefferson
Address: 10538 Versailles Blvd
City: Wellington State: FL
Zip Code: 33467 Fax:
Phone No. 561-969-3112
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
11 VORUC U1 LUn-Iuuwun ns ;icauu or more, a KtLUKutu Notice of commencement is required.
EER: - Not Applicable -
Name: Tilteco Inc.
Address: 6355 NW 36th St Suite 305
City: Virginia Gardens State: FL
Zip: 33766 Phone:
MORTGAGE COMPANY: x Not Applicable.'
Name:
Address:
City: State:
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 your Notice of Commencement.
_ s
Signature of Owner Lessee/Contractor gent for Owner Signature of Contractor/License er
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFSt. Lucie COUNTY OFScLecle
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 1 20 �l by this �i day of 20 L by
Michael Heisse4g 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 QhaReR G,Shea
r � o� s N�FARY PUBLIC
Commission No. -; , b ' aot Shanon O'Shea Commission No. MATE OF FLORIDA
NOTARY PUBLI
y STATE OF FLOR DA ? Comm# GG258038
iti a
Revised 07/15/2014
Expires 9/12/2022
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