HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi
ALL APPLICABLE INFO /MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 2
Date: I Permit Number: O J�
SCANNED
0
St. L ie Cou fv
Building Perm Uit Application APR 12 2017
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
PERMITTING
St. Lucie County, FL
Residential
PERMIT APPLICATION FOR: Shutter III
Address: 9425 S Ocean DR Apt 64
Legal Description: ISLAND VILLAGE PHASE 11 BLDG 9 UNIT 64
Property Tax ID #: 3535-333-0001-760-7
Site Plan Name: Ernest L Rudd
Project Name:
Setbacks Front Back: Right Side: Left Side:
Install 6 Accordion Shutters
Lot No.
Block No.
lanai worK co oe
HVAC
err0rmea unuer tms
Gas Tank ❑Gas
permit— cnecK all apply:
17
Piping _Shutters ❑
Windows/Doors
Electric
0 Plumbing
Sprinklers Generator
Roof
Total Sq. Ft of Construction:
Cost of Construction: $ 2067.00
S Ft. of First Floor: _
Utilities: Sewer 0- Septic
Building Height: 30'
OWNER/LESSE
16ONTRACTOR:
Name Ernest L Rudd
Name: Michael Heisenberg
Address: 9425 S Ocean DR Apt 64
Company: Expert Shutters
City: Jensen Beach State: FL
Zip Code: 34957 Fax:
Phone No.954-397-8165
Address: 668 SW Whitmore Dr
City: Port St Lucie State: FL
Zip Code: 34984 Fax: 772-871-0990
Phone No. 772-871-1915
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: Callexpert@AOL.com
State or County License: 16572
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
3UPPLEMENTALCONSTR-I P_0N LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: Tillew,lnc.
MORTGAGE COMPANY: X Not Applicable
Name:
Address: 6355 NW 36th Sl4305
Address:
City: Virginia Gardens State: FL
Zip: 33166 Phone: 305A71-1530
City: State:
Zip: Phone -
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 1 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 inspection. If you iptend to obtain financing, consult with lender or an attorney before
_ Signature of Owner/
STATE OF COUNTY OF FLORIDA ` 1 ` �uC Ir Q COUNTY OF STATE OF FLORIDA 54,
1 Lu Cj
The for�oing instrument was acknowledged before me
this��ayof(y\0lJ(,1^ 20 aby
Michael Heissenberg
(Name of person acknowledging)
V/" %1 7fV
(Signature of Notary Public -State of Flo a
Personally Known x OR Produced Identification
Type of Identification Produced
The forVng instrument was acknowledged before me
�� this day of � C7/( 20 0 by
Michel Heissenberg
(Name of person acknowledging
a
no�wledgingg I
fp
(Signature of Notary Public- State o6fq64a )
Personally Known X OR Produced Identification
Type of Identification Produced
Commission N . (Seal) Commission N4-- Iba�� �„WER VIZZO
t#RYgr HEATHER VIZZO a �� o� NOTARY PUBLIC
a4 T,aRv vl IRLIC l c�"+' t�/� E
o���s ` \ J d3 y\�r Crnnn# FF1762E6
g �`f'"'�9 k5�' ATE OF; FLORIDA S5 e
Revised07/15/2014 g_�,�\\.:. Com •Fi.62�6 ce19� Expires11/13/2018
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