HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:�-?T a( Permit Number:
RECEIVED
Building Permit Application 1021
Planning and Development Services Wit,L 40i, PO,41Ffj
Building and Code Regulation Division Permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Shutter
PRO
PQ5ED )MPRQ1tEM,ENT.LDCATIt
Address:
7410 S OCEAN DR 808
Legal Description: SAND DOLLAR VILLAS CONDOMINIUM D-UNIT 808 AND UND PRO-RATA SHAREIN COMMON ELEMENTS
Property Tax ID#: 3522-605-0045-000-6 Lot No.
Site Plan Name: Block No.
Project Name: Kliebisch
Setbacks Front X Back: Right Side: Left Side:
ITAILEa DESCRIPTION tJF WORK fi fin f
Install 2 accordion shutters
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CONSTRUCTf}N INFOR{1%IA'fIQN x �
r,
itiona work to orme an er t ispermit—c ec a appy:
11HVAC fl Gas Tank Gas Piping 10 Shutters Windows Doors
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Electric ❑ Plumbing Sprinklers M Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ 1,066.00 Utilities:CnSewer Septic Building Height:
OWNER/LESE>F CONTRACTQRIff
e
Name Henry Kliebisch Louise Kliebisch Name: Michael Heissenberg
Address:10 Starrett Ct Company: Expert Shutter Services
City: Sparta State:NJ Address: 668 SW,Whitmore Dr
Zip Code: 07871 Fax: City: Port Saint Lucie State:FL
Phone No.201-805-7573 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.
a 13N T tt,-C LIEN i.R1�11 1 d iVIAT!`ON
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DESIGNER/ENGINEER _Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Tit}eco Name:
Address: \o35S 'two 31n}" b-Ir Swoc 305 Address: !
City: y vroanma Cra(ae ns State: V 1_ City: State:
Zip: Phone Zip: Phone:
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FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
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.
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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 anotlier non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in paying twice for
improvements to your property. A Notice of Commencement must be recordedjin the public records of St.
Lucie County 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.
Signature of Owner/Lessee/Contract as Agent for Owner Signature of Contractor/License Hol
STATE OF FLO�I1DA, STATE OF FLORIDA
COUNTY OF COUNTY OF ii,CiQ
Sworn to(or affirmed)and subscribed before me of Swop to(or affirmed)and subscribed before me of
physical Presence or Online Notarization V Physical Pres nce or Online Notarization
this t9- day of 12020 by this day of 2020 by
Name of person makingstatement. Name of person making statement.
Personally Known V/ OR Produced Identification Personally Known! �✓ OR Produced Identification
Type of Identification Type of Identification
Produced Produced r
aI
001LOL () — &A&A C� n ( ,
(Signature of Notary Public-State of Florida) (aSignature of Notary Public-State of Ft �i�la) Shanon O'Shea
ow
-W& Shanon O'S e oho , NOTARY PUBLIC
aa�� NOTARY P B O
Commission No. "'C �V � o �b�nmission No \ `� (Jix ( MATE OF FLORID
-STATE OF F LORIDA � n
y Comm#GG 58038 �=Comm#GG258038
R E 19lo Expires 9/ 2/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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