HomeMy WebLinkAboutBUILDING PERMIT APPLICATION- --
ALL APPLICABLE INFO MUST 0ECOMPLETED FOR APPLICATION TQ0E ACCEPTED
Date: SCANNED Permit Number: 00
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Planning and Development Services pERJ4/77lNG
Building and Code Regulation Division St. Lucie Cnun�.pL
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Phone: (77Z)46Z'l553Fax: (77l)462'1578 Commercial R8SideDtiJl___________
PERMIT APPLICATION FOR: Shutter
Address: 9000SOcean Or#104
Legal Description: Empress Condominium Unit 104
Property Tax |D#: 00-5 Lot No.
Site Plan Name: Block No.
Project Name: Campbell
Setbacks Front Back: }( Right Side: Left Side:
_________
Install I Accordion Shutter
11 Electric Plumbing OSprinklers 0 Generator Roof Roof pitch
Total Sq. FtofConstruction: S Ft of First
Cost ofConstruction: $ 2002.00 Utilities:| |SevverE]3eptic Building Height: y|
Name James Campbell
Name: Michael Heissenberg
Address: P 0 BOX 534
Company: Expert Shutter Services
City: Newport State: VT
Zip Code: 05855 Fax:
Phone No. 802-999-7781
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 I if different
from the Owner listed above)
E-Mail: Callexpert@aol.com
State or County License: 16572
ir vaiue or consiruction is *z�uu or more, a MtLUKUhU Notice of Commencement is required.
SUPPLEMENTAL_CONSTRUCTION LIEN .LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: Tiltecoinc.
MORTGAGE COMPANY:
Name:
x Not Applicable
Add reSS: 6355 NW 36th St Suite 305
Address:
City: Virginia Gardens State: FL
Zip: 33166 Phone:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
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 inspection. If you intend to/otain financing, consult with lender or an attorney before
as Agent
STATE OF FLORIDA
COUNTY OF (;i—
The forgoing instrument was acknowledged before me
this,';;25dayof 20i0by
STATE OF FLORIDA
COUNTY OF ,g), LLr 9 -f
The forgoing instrument was acknowledged before me
this day of /Y b,° Y . 20 JJ_ by
Michael Heissenberg Michael Hsissenberg
(Name of person acknowledging) (Name of person acknowledging j
.L/a� QiL c�1A--
(Signature 0otary Public- State of Florida j
Personally Known OR Produced Identification
Type of Identification Produced
Commission NonG'T ILI q.3LI Z
Revised 07/15/2014
(SlIgnature of Vry Pu lic-State of Florida )
Personally Known �/ OR Produced Identification
Type of Identification Produced
Haleigh Short I Commission NoaC—IIL42-3 Z
NOTARY PUBLjJ
STATE OF FL O IDA !S�U
Expires 5/25/2021
(Seal)
Halegh Short
STATE OF FLORIDA
Comm# GG148342
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