HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q
Date:;k Permit Number: aad' 1�5
RECEIVED
Building Permit Application MAR 2 9 2022
Planning and Development Services
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Building and Code Regulation Division Commercial X Residential PatmlStlna
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: Hurricane Shutters
Address: 3200 N HIGHWAY A1A 207
Property Tax ID #: 1425-600-0013-000-4
Site Plan Name:
Project Name: Helma
Install 1 crank roll & 3 accordion shutters
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
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction:
Cost of Construction: $ 6,106.00
Sq. Ft. of First Floor:
Lot No.
Block No.
Windows/Doors _ Pond
Roof Pitch
Utilities: —Sewer —Septic Building Height:
T & k� �A E..lb�'�
X0WRACTOR:�, ��
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Name Thomas & Jeanne Helma
Name: Michael Heissenberg
Address:3571 Post Rd
Company: Expert Shutter Services
Address: 668 SW Whitmore Drive
city: Wakefield State:Rl
Zip Code: 02879 - Fax:
Phone No. 401-369-6591 E-
City: Port Saint Lucie State: FL
Zip Code: 34984 Fax:
Phone N0772-871-1915
E-Mail Permits@expertshutters.com
State or County License 16572
Mail:
Fill in fee simple Title Holder on next page (if different
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.
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K"11101mo
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: Tilteco, Inc.
Name:
Address:
Address: 6355 NW 36th St. #305
City: Virginia Gardens State: FL
City: State:
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 commencine work or recording vour Notice of Commencement.
Signature of Owner Lessee/Contracto s 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 o I entification Produced
(Signature of Notary Public- State of Florida)
Shanon 'S�a
NOTARY PUBLIC
Commission No. GG258036 (Seal)STATE
OF FLORIDA
T.,
Comm# GG258038
Expires 9/12/2022
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Rev 5/10/11