HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5)10 �1 Permit Number:
RECEIVED MAY 24 2017
Building 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 Residential
PERMIT APPLICATION FOR: Shutter
PROPQSED IIUIPRUEMEN? LO:CATIQN It
Address: 10102 S Ocean Dr Apt 202A
Legal Description: ATLANTIS CONDOMINIUM BLDG A UNIT202A
Property Tax ID #: 4502-802-0009-000-8 Lot No.
Site Plan Name: Florence T Hays Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
[17ETAILED "POCRIT?1'ION :OF WQRK
a. ,. a ..
Install 1 Accordion Shutter
Additional work to be nertormed under tills permit — cnecK all apply:
E1HVAC Gas Tank Gas Piping Shutters ❑ Windows/Doors
11 Electric E] Plumbing O Sprinklers 1:1 Generator Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 1442.00 Utilities:'n Sewer []Septic Building Height: 60'
.
01NNER/LESSEE s`'
Ct1NTRACTOR' '
Name Florence T Hays
Name: Michael Heissenberg
Address:10102 S Ocean Dr Apt 202A
Company: Expert Shutters
city: Jensen Beach State: FL
Address: 668 SW Whitmore
Zip Code: 34957 Fax:
City: Port St Lucie State: FL
Phone No. 772-229-1226
Zip Code: 34984 Fax:
E-Mail:
Phone No. 772-871-1915
E-Mail: callexpert@aol.com
Fill in fee simple Title Holder on next page (if different
State or County License: 16572
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is regwrea.
SUPPLEMENTAL CQNSTRUCTION LIEN LAW INFORMATION..
�:.�
ESIGNER/ENGINEER: _ Not Applicable
Name: walterTillit
MORTGAGE COMPANY: x Not Applicable
Name:
Address:
City: State:
Zip: Phone:
Address: 6355 NW 36th St
City: Virginia Gardens State: FL
Zip: 33168 Phone: 305.871-1530
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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 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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspeIf you intend toobtain financing, consult with lende n attorney before
commencing world or reco g pur Not�of Commencement.
_ Signature of Owner/ Lessee/Agent
Signature
Holder
STATE OF FLORIDA � Ly C 1 / /J STATE OF FLORIDA C L J L� U (11(
COUNTY OF '� COUNTY OF .J'] ,
The forg ling instrument was acknowledged before me
this � ay of Q� 20 _by
Michael Heissen4g
(Name of person acknowledging)
(Signature of Notary70R
c- State ovi ida )
Personally Known Produced Identification
Type of Identification Produced
Commission
Revised 07/15/2014
H ATHER VI2ZO
1� TARY PUBLIC
STATE OF FLORIDA
Expires 11/13/2018
The forgp%ng instrument was acknowledged �before me
this "slay of L L
20 by
Michael Heissenberg
(Name of person acknowledging )
9V�
(Signature of Notary Public State olylgida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission Noqa10 �a�WyQs eN
Ik �TARY PUBL?O
STATE OF FLORIDA
Comm# FF176266
Expires 11/13/2018
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