HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
D � �
Planning and Development Services
I?ECI-EaVE:D
Building Permit Application FEB 01 2022
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: Hurricane Shutters
STD L icie County, �r mitting
Residential. --
Address: 4250 N Highway A1A Apt 906
Property Tax ID #: 1423-501-0070-000-1 Lot No.
Site Plan Name:
Project Name: Pepin
Install 1 accordion shutter
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit —check all that apply:
(Affidavit required)
Block No.
Mechanical _ Gas Tank _ Gas Piping X Shutters _ Windows/Doors _ Pond
Electric
Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 2,476.00
_ Sprinklers
Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
Name George & Carole Pepin Name: Michael Heissenberg
Address: 4250 N Highway A1A Apt 906 Company: Expert Shutter Services
City:. Hutchinson Island State: FL Address: 668 SW Whitmore Drive
Zip Code: 34949 Fax: city: Port Saint Lucie State: FL
Phone No. 781-424-8517 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
from the Owner listed above) State or County License 16572
IT value or construction is zbuu or more, a KECUKDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
DES
Not App
Name: Tilteco, Inc.
Address: 6355 NW 36thSt. #305
City: Virginia Gardens State: FL
Zip:33166 Phone
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: 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 ggranting a permit will authorize the permit holder to build the subject structure
which conflicts with any applicable Homeowners%sociatlon rules, bylaws or and."covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in 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 attornev before commencing work or recording vour Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agen r Owner
STATE OF FLORIDA
COUNTY OF St. Lucie
Sworn -to (or affirme and subscribed bef re me of x
this day �In 20 �by
Physical Presence or Online Notarization
of
Michael Heissenberg
Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
iA ,nof
(Signature of Notary Public- State of Florida)
otpRyAss Shanon O'Shea
Commission No. GG258038 (Seal)
o� n NOTARY PUBLIC
-STATE OF FLORIDA
a Comm# GG258038
El eExpires 9/12/2022
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Rev 5/20/21