HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED�%
Date: TllT_ oY� SCANI�>�U rrpitNumber: V in .0
BY -fit E_EVE[d
_ St. Lucie Countv
Building Permit Application APR 12 2017
Planning and Development Services PERMITTING
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Shutter III
Address: 9650 S Ocean Dr Apt 903
Legal Description: THE PRINCESS OF HUTCHINSON ISLAND UNIT 903
Property Tax ID #: 4502-610-0083-000-1
Site Plan Name: Erika M Burtnik
Project Name:
Setbacks Front Back:
Install 1 Accordion Shutter
Right Side:
HVAC LJ Gas Tank UGas Piping
Electric 0 Plumbing ❑Sprinklers
Total Sq. Ft of Construction: _
Cost of Construction: $ 3531.00
Lot No.
Block No.
Left Side:
Shutters ❑ Windows/Doors
Generator Roof
S Ft. of First Floor: _
Utilities:Sewer OSeptic
Building Height: 170'
OWNER%ESSEE •mar": N
CONTRATCOR
Name Erika M Burtnik
Name: Michael Heisenberg
Address:9650 S Ocean Dr Apt 903
Company: Expert Shutters
City: Jensen Beach State: FL
Zip Code: 34957 Fax:
Phone No. 772-229-1393
Address: 668 SW Whitmore Dr
City: Port St Lucie
Zip Code: 34984 Fax:
Phone No. 772-871-1915
State. FL
772-871-0990
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.
SUPPLEMENTAL CONSTRUCTION IEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: Tiilteco,mc.
MORTGAGE COMPANY: X Not Applicable
Name:
Address: 6355 NW 36th St #305
Address:
City: Yrginia 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 ano 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 inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work clpfecmdine vouvNotice of Commencement. n---n /
_ Signature
STATE OF STATE OF FL
COUNTYOFORIDA 51LLi C(-Q COUNTY OFORIDA 34,
LUC, _e
The forgVng instrument was acknowledged before me The for IVng instrument was acknowledged before me
this�8ayof nia/CL. 201-1 by thij day of MQ�( In 20 11 by
Michael Heissenbing Michel Heissenberg
(Name of person acknowledging)
(Name of person acknowledging
g)
V
(Signature of Notary Public- State of F(o i ) (Signature of Notary Public- State o a )
Personally Known X OR Produced Identification
Type of Identification Produced -
Commission Nl:/�1b OI`o (Sa)\THER VIVO
ta�ar - If, HOTFRY PUBLIC _
Personally Known x OR Produced Identification.
Type of Identification Produced /I Commission N �a �P 6EAISM) VIZ.ZO
NOTARY PUBLIC
Revised 07/15/2014 t'4 < cc�""#? Fs 17sass u c„n y> F17 a
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