HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
S_Z, LLULIL
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 4909 PALM DR
Property Tax ID #: 3402-608-0170-000-1 Lot No.
Site Plan Name: Block No.
Project Name: Hickox
_..............�............................
❑ETAILED DESCRIPTION OF WORK:
Install 11 accordion shutters
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
—Mechanical _ Gas Tank —Gas Piping X Shutters Windows/Doors _ Pond
_ Electric ` Plumbing _ Sprinklers — Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 4,299.00 Utilities: — Sewer _ Septic Building Height:
_.. .m............... _.......
O1 . Y F LESSEE: CONTRACTOR: -
----.........
Name Elizabeth F Hickox
Name: Michael Heissenberg
Address: 4909 P21m ❑r_
Company: Expert Shutter Services
_ ,
City: FQrt Pmerce state: FL
Address: 668 SW Whitmore Drive
City: Port Saint Lucie State: FL
Zip Code: 34982 Fax:
Phone No. 772-497-4187 E-
Zip Code: 34984 Fax:
Mail:
Phone No772-871-1915
Fill in fee simple Title Holder on next page (if different
E-Mail permits@expertshutters.com
State or County License 16572
from the Owner listed above)
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER:
Name: Tilleco Inc.
Address: 6355 Nw 36th St Solt.305
City: Virginia Gardens
zip: 33168 Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Add ress:
City:
Zip: Phone:
Not Applica
State: FL
x Not Applicable
MORTGAGE COMPANY:
Name:
Add ress:
city:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
x Not Applicable
State:
;Not Applicable
I certify that no work or instaliation 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 5t. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review; room additions,
accessory structures, swimming pools, fences, wails, 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 recordin our Notice of Commencement.
Signature of Owner/Lessee/Contra r as Agent for Owner
STATE OF FLORIDA
COUNTY OF sl. L.i.
The forgoing instrument was acknowledged before me
this?- day of 20 t� by
Michael Heissenbft
{Name of person acknowledging)
{Signature of Notary Public- State of Florida }
Personally Known x OR Produced Identification
Type of Identification Produced Shoa
Commission No. GG25803s NOTARY PUBLIC
i.tComrn-#GG25ff
STATE OF FLOR
Revised 07/ 15/2014
Signature of antractor/License der 5
STATE OF FLORIDA
COUNTY OF St. Lucie
The forgoing instrument was acknowledged before me
this 2 day of 20 Z% by
Michael Heissenberg
(Name of person acknowledging }
{Signature of Notary Public- State of Florida I
Personally Known x OR Produced Identification
Type of Identification Produced
anon
Commission No. GG258038 tARY TARY PUBLIC
5 ATE OF FLOR0-
Comm# GG258038
►9 Expires 9
REVIEWS FRONT ZONING SUPERVISOR PLANS
DATE COUNTER REVIEW REVIEW REVIEW
COMPLETE
INITIALS
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW