HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
4.`.
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
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Commercial X Residential
CBDG Funding
PERMIT APPLICATION FOR: Hurricane Shutters
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Address: 7410 S Ocean Dr #810
Property Tax ID #: 3522-605-0047-000-0 Lot No.
Site Plan Name: Block No.
Project Name: Bugay
Install 1 accordion sh
New Electrical Meter Second Electrical Meter
(Affidavit required)
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping X Shutters _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cost of Construction: $ 9,037.00 Utilities: —Sewer —Septic
Building Height:
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Name Norman W Bugay
Name: Michael Heissenberq
Address: 7410 S Ocean Dr #810
Company: Expert Shutter Services
city: Jensen Beach State: FL
Zip Code: 34957 Fax:
Phone No.216-536-1437 E-
Address: 668 SW Whitmore Drive
City: Port Saint Lucie State: FL
Zip Code: 34984 Fax:
Phone No772-871-1915
E-mail Permits@expertshutters.com
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State or County License 16572
it value of construction is Z500 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.
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DESIGNER/ENGINEER: _
Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name: Tilteco, Inc.
Name:
Address:
Address: 6355 NW 36thSt. #305
.City:
State:
City: Virginia Gardens State: FL
Zip: 33166 Phone
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 granting a permit will authorize the permit holder to build the subject structure
which conflicts with any. applicable Homeowners Association 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 your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF St. Lucie
Sworn to (or affirmed) and subscribed before me of X Physical Presence or Online Notarization
this _ day of , 20_ by
Michael Heissenberg
Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification Produced
(Signature of Notary Public- State of Florida)
Commission No. GG256036 (Seal)
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