HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: J4UnOC) apnl -4S Permit Numlle
Ae BY
C13NNVOS St. Lucie County
Building Permit Application �������®
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 AUG 2 3 2017
Phone:(772)462-1553 Fax:(772)462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Shutter III
Address: 10200 S Ocean DR PH-7
Legal Description: ATLANTIS III BY THE SEA UNIT PH7(707) AND PRO-RATA SHARE IN COMMONELEMENTS
Property Tax ID q: 4511-518-0065-000-4
Site Plan Name:
Project Name: Pothiawala
Setbacks Front Back: X
Install 2 Accordian Shutters
HVAC I_J Gas Tank
Electric 0 Plumbing
Total Sq. Ft of Construction: _
Cost of Construction: $ 2114.00
Right Side: Left Side:
mt— cnecKau appiy:
Piping _Shutters
nklers Generator
S Ft. of First Floor: _
Utilities:Sewer OSeptic
Lot No.
Block No.
Windows/Doors
Roof = Roof pitch
Building Height:
.CONTRACTOR:
Na me Amin Pothiawala
Name: Michael Heissenberg
Address:31 WinterlaneCIR
Company: Expert Shutter Services
City: Essex Junction State: VT
Zip Code: 05452 Fax:
Phone No. 802-578-8980
Address: 668 SW Whitmore or
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
1T vame or construction is yzsuu or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTA"L COtdSTEiUC�TION LIEN L�\1N
�PJFOFtMATION
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:
X Not Applicable
Name: Tiltewlnc.
Name:
Address: 6355 NW 36th St Suite 305
Address:
City: Virginia Gardens
State: FL
City:
State:
Zip: 33166 Phone:
Zip:
Phone:
FEE SIMPLE TITLE HOLDER:
= Not Applicable
BONDING COMPANY:
Not Applicable
Name:
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 inspection. If you intend tp� obtain financing, consult with lender or an attorney before
commencing work o cx�3ilaevour Nj&ce of Commpnrpmpnt_ - q l/
STATE OF FLORIDA
COUNTY OF St was
The forgotng instrument was acknowledged before me
thisCC5 day of Q(.A',S 20aby
Michael Heissen i
(Name of person acknowledging)
Personally KnowH y
Type of Identification Pn
Commission
OR Produced Identification
STATE OF FLORIDA
COUNTY OF st was
The forgoing instrument was acknowledged before me
this QM day of f"Q l=,20 flby
Michael Hsissenberg
(Name of person acknowledging)
State of Florida )
Personally Known " OR Produced Identification
Type of Identification Produced
Haleigh RusseA
NOTARYPUBU Commission
STATE OF FLOR DA
tlelogh Russell
NOTARY PUBLIC
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— Revised 07/15/2014 — ° Ecpires5/2512021 3�Ccmrn#GG108399
- —
Expires 5/25/2021
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