HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q
Date: �`��a3. Permit Number: aa'�i Q;�� 1
RECEIVL
MAC 2 9 2022
Building Permit Application
Planning and Development Services
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Building and Code Regulation Division Commercial X Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: Hurricane Shutters
Address:9650 S OCEAN DR 804
Property Tax ID #: 4502-610-0074-000-5
Site Plan Name:
Proiect Name: Nicholson
rnstauaiion UT I mccoralon onuiter
New Electrical Meter Second Electrical Meter
Affidavit re uire
( q Id )
Lot No.
Block No.
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping X Shutters _ Window's/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 4,319.00 Utilities: —Sewer _Septic Building Height:
OWNER/LESSIE G
CCITRAGTOR.
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Name Brian J Nicholson Marie P Nicholson
Name: Michael Heissenberg
Address: 5555 Netherland AVE Apt 2C
Company: Expert Shutter Services
City: Bronx State: NY
Zip Code:10471-2336 Fax:
Phone No. 917-569-2149 E-
Address: 668 SW Whitmore Drive
city: Port Saint Lucie State: FL
Zip Code: 34984 ! Fax:
Phone No772-871-1915 !
Mail: iohnmcondon W-comcast.net
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail Permits@expertshutters.com
State or County License 16572
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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.
EJPPLEII4'AL�}NSTL! �IiN.�l:EN LAWS l�C}RMTt;�����
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DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name: rilteco, Inc.
Name:
Address: 6355 NW 36thSt. #305
Address:
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:
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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.
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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 restrictionslwhlch 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 Ow er/ Lessee/Contrac as Agent for Owner
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STATE OF FLORIDA
COUNTY OF St. Lucie
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Sworn to, or affirmed) and subscribed before me of x
Physical Presence or Online Notarization
his t` ��ayof QL 20` Zby
Michael Heissenberg
Name of person making statement.
Personally Known x OR Produced Identification
Type of Identtiiffiica,tiioon Produced
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(Signature of Notary Public- State of Florida)
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Commission No. GG258038 (Seal)
KELLY ROSE A
17through
otary Public - StaFloridaCommission
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# H416
Comm. Exaires 4, 2626ry
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DATE
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DATE
COMPLETED
ev 5/20/21