HomeMy WebLinkAboutBUILDING PERMIT APPLICATION I
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
DECEIVED
i � 1� ���� Permit Number:
w.z � �« DEC X 6 2021
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BuilsIng 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 Resideitial
PERMIT APPLICATION FOR: Shutter
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Address: 4180 N Highway A1A# 1302B
Legal Description: OCEANIQUE OCEANFRONT(OR 2752-1842) BLDG B UNIT 1302
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Property Tax ID#: 1423-506-0141-000-5 Lot No.
Site Plan Name: Block No.
Project Name: Conway
Setbacks Front X Back: Right Side: Left Side:
DETA)tLED DESCRIP'fIOIV; F WORK r
Install 1 manual roll shutter
CgNSTRUCTION INFORMATION_ ��� ��
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Additional work to be nertormed under t is permit lapply: �—check a
11HVAC Gas Tank ❑Gas Piping Shutters Windows Doors
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Electric ❑Plumbing Sprinklers a Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ 2,059.00 Utilities: Sewer Septic BuIilding Height:
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011VNER/LESSEE CONTRACTaR'
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Name Ted&Theresa Conway Name: Michael Heissenberg
Address:4180 N Highway A1A#1302B Company: Expert Shutter Sery ces
City: Hutchinson Island State:FL Address: 668 SW'Whitmore Drl
Zip Code: 34949 Fax: City: Port Saint Lucie I State:FL
Phone No.407-322-1645 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
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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.
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�SLI'RPLEME T�L CONSTRUCTION LIENLAVI! (NF4RMTiON '
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: TiltecoInc.. Name:
Address:6355 NW 36th St Suite 305 Address:
City: Virginia Gardens State: FL. City: State:
Zip: 33166 Phone: Zip: .Phone: 1
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FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: 'Phone:
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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 restrictio i s 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 pour 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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ignature of Own e Lessee/Contractor a ent for Owner Signature of Contra or/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF St.Lucie COUNTY OF St.L-
The forgoing instr ment was acknowledged before me The forgoing instrument was ackn wledged before me
this J5 day of 20 C� by this_L5 day of (?. ,20 al by
Michael Heissen4g Michael Heissenberg
(Name of person acknowledging) (Name of person acknowledging)
( ?LAX
(Signature of Notary Public-State of Florida) (Signature ofNotary Public-State of Florida)
Personally Known x OR Produced Identification Personally Known x OR Pr l �d IdengiaatUlShea
Type of Identification Produced Shea Type of Identification Produced sNOTARY PUBLIC
o�Ass Shanon O; Q
�' NOTARY t USLIC '—STATE OF FLORIDA
Commission No. GG258038 �Q ( LL ITE CIF FLORIDA Commission No. GG258038 t a&A6 GG258038
W 2'Con•Im#GG258036 s�NCE 19 Expires 9/12/2022
CE 1 Expires 91121022
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW (REVIEW REVIEW
DATE
COMPLETE
INITIALS
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