HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED -t q
Date:- RECEIVE Permit Number: 1a1"dd� 1
JUL 0 6 2017
SCANNED
Building Permit Application BY
Planning and Development Services St. Lucie County
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
Address: 9600 S OCEAN DR 1107
Legal Description: EMPRESS CONDOMINIUM UNIT 1107
Property Tax ID #: 4502-620-0088-000-7
Site Plan Name:
Project Name: PEDERSEN
Setbacks Front Back: X
INSTALL 3 ACCORDIAN SHUTTERS
�HVAC Li Gas Tank
Electric 0 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 3,450.00
Right Side:
Piping
Sprinklers
Left Side:
IVI Shutters
11 Generator
S Ft. of First Floor: _
Utilities: Sewer [] Septic
Lot No.
Block No.
❑Windows/Doors
DRoof = Roof pitch
Building Height:
OWlUERJLESSEE �'
k ,
CONTRACTOR x;
Name Dennis E Pedersen
Name: Michael Heissenberg
Address:17825 Gardenia Ln
Company: Expert Shutter Services
City: Clinton Township State: Ml
Zip Code: 48036 Fax:
Phone No.586-871-8129
Address: 668 SW Whitmore Dr
City: Port Saint 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
It value of construction IS SZsuU or more, a RECORDED Notice of Commencement is required.
llP�L EI i4L G( NS' U�CTl01V"L1 NIA IV INF
�.
RMATIQ E "iE,
DESIGNER/ENGINEER: _ Not Applicable
Name: Tiiteminc.
MORTGAGE COMPANY: x Not Applicable
Name:
Address: 6355 NW 36th St suite 305
Address:
City: VlrginiaGardens State: FL
Zip:331as Phone:
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 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 Notic of Commencement must be recorded and posted on the jobsite
before the first insp on. If you intergto obtain financing, consult with lender or an aga[ney befVe
Signature
STATE OF FLQFl1DA STATE OF FLORIDA
COUNTY OF t 1 J ,LGF-P COUNTY OF �S* �J (� l
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this---3dayof31 It L.1 20 j-Lby thisaday of 20 I —a by
Michael Heissenbkg Michael Hsissenberg
(Name of person acknowledging) (Name of person acknowledging)
of Not*y Pub jc- State of Florida )
Personally KnMn V OR Produced Identification Personally KnovJK " OR Produced Identification
Type of Identification Produced Type of Identification Produced
HaW/� / Russel! J p
Commission N06603q'q ( NOTARY Bommission Nc>(_11� 1�� SJ I a= Russell
;STATE OF LOiiU, - OTARYPUBLIC
Conardf �o _STATE OF FLORIDi
Comm#GGI1 Expires 5/25/20� , OKExpires 5/2512
99
Revised 07/15/2014 021
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
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DATE
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INITIALS