HomeMy WebLinkAboutBUILDING PERMIT APPLICATION (2)z
ALL APPLICABLE INFO MUST BE COMPLff6Rt59FaVRgCfgION TO BE ACCEPTED
Date: AS SLP.9RA5nber: �� " D y3A
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_ 43NNVOS BY
11116
St. Lucie Court" RECEOVE
.® Building Permit Application
Planning and Development Services AUG 2 3 2017
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 III
Address: 9600 S Ocean Dr #1406
Legal Description: Empress Condominium #1406
Property Tax ID #: 4502-620-0105-000-3
Site Plan Name:
Project Name: Samuels
Setbacks FrontX Back: X
Install 3 Accordian Shutters
11HVAC LJ Gas Tank
11Electric ElPlumbing
Total Sq. Ft of Construction: _
Cost of Construction: $ 3450.00
Lot No.
Block No.
Right Side: Left Side:
L
Piping ❑_Shutters Windows/Doors
nklers 11 Generator Roof = Roof pitch
S Ft. of First Floor: _
Utilities:cnSewer Septic
Building Height:
01(UNi/LESSEE
CONTRACTOR �_.
Name Nancy Samuels
Name: Michael Heissenberg
Address:9600 South Ocean Drive #1406
Company: Expert Shutter Services
City: Jensen Beach State: FL
Zip Code: 34957 Fax:
Phone No.410430-9059
Address: 668 SW Whitmore or
City: Port Saint Lucie State: FL
Zip Cade: 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.
5UPPLEMEt iALCONSIRUCTIOtd Lo LAIN INF,ORMA1lON
x a
`
DESIGNER/ENGINEER: _
Name: Tiitecoine.
Not Applicable
MORTGAGE COMPANY:
Name:
X Not Applicable
Address: 6355 NW 36th St Suite 305
Address:
City: Virginia Gardens
Zip:33166 Phone:
State: FL
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: =
Name:
Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
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 inspectloA4 you intend o obtain financing, consult with len or an attor7y before
commencing work oy-recorclinR your Udtice of Commencement.
STATE OF FLORIDA
COUNTY OFstwWa
STATE OF FLORIDA
COUNTY OF StLud.
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thisCEdayof ii1ACJ\1.S+— 20 aby this Q %day of-OO_WGA- 20 nby
Michael Heissen4ii Michael Hsissenberg
(Name of person acknowledging) (Name of person acknowledging )
"� �
ignature of otary Publiy- State of Florida )
Personally Known �// OR Produced Identification
Type of Identification Produced nn
Commission No. --1 'I1og3q 7 �o Hash Rp�l
�i V'TAAR
�'r�. srwTE OF FCO
Revised 07/15/2014
( gnature of N t ry Public- State of Florida )
Personally Known ✓/ OR Produced Identification
Type of Identification Produced
Expires
s 5/2512021
Ex
No.
Expires
FLORIDA
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS