HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �QQ
Date: Permit Number: �D DUU
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
PRQPC?SED i !?ROfEMENT LC+CATti ,;.
Address: 3000 N HIGHWAY A1A 5C
Legal Description: THE ATRIUM ON THE OCEAN it (OR 1558-594) UNIT 5-C
Property Tax ID#: 1425-756-0015-000-8 Lot No.
Site Plan Name: Block No.
Project Name:.Chouris
Setbacks Front Back: X Right Side: Left Side:
dETAII.ED D "CRIPTIb A0, WORK p ,
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Install 1 accordion shutter
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CaNSTRUCTION INFORMATION ,d F
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Additionalworktone e orme under this permit—check a apply:"
E]HVAC E]Gas Tank Gas Piping Shutters Windows/Doors
11 Electric ❑Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 6,268.00 Utilities:In Sewer O Septic Building Height:
OUt/NELESSEE• CONTR
R/ ACT4OwRF
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Name Victoria Chouris&Tobin Notman Name: Michael Heissenberg
Address:869 Whippoorwill Blvd. Company: Expert Shutter Services
City: West Palm Beach State:FL Address: 668 SW Whitmore Dr
Zip Code: 33411 Fax: City: Port Saint Lucie State:FL
Phone No.561-236-1743 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.
sIPPLEMENTAL 0QN5TR77IN;LIEN lA1N INFORMATION ` , ..=3,' �
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Tiltecolnc. 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/Contrac as Agent for Owner Ignature of Contractor/License Hold
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF St.Lucie COUNTY OF St.Lucie
The f rgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this LZo day of (`)C:ti'• 20 QLby this O day of 20 al by
Michael Heissenbirg 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
QType of Identification Produced
��R5 0'A 2 ll &OIRI anon 2 ? y aCommission No. NOTARY PUBLI Commission No. �Jf� ''�� NOTARY PUBLICSTATE OF FLOR DA STATE OF FLORIDComm#GG2580 8 a Comm#GG258038
RE IS Expires 9/12/2022 *cE e1 Expires
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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INITIALS