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Date: 3�°���� PermitNumber:C� JJd�ro 1'
RECEIVED
Building Permit Application MAR 0 2 201E
Planning and Development Services ST. Lucie County, Permitting
Building and Lode Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x Residential
PERMIT APPLICATION FOR: Shutter— .0 I
Address: 9600 S Ocean Dr #1504
Legal Description: EMPRESS CONDOMINIUM UNIT 1504 (OR
Property Tax ID #: 4502-620-0112-000-5
Site Plan Name:
Project Name: Kelly
Setbacks Front Back: x Right Side:
Install 3 accordion shutters
�HVAC Gas Tank ❑Gas Piping
Electric Plumbing []Sprinklers
Total Sq. Ft of Construction: _
Cost of Construction: $ 4,018.00
Lot No.
Block No.
Left Side:
apply:
Shutters Windows/Doors
Generator Roof = Roof pitch
S Ft. of First Floor: _
Utilities:cn Sewer 11 Septic
Building Height:
d1lVNER/LESSEE
v
CONTRACTOR::
Name Daniel & Kathleen Kelly
Name: Michael Heissenberg
Address:6600 S Ocean Dr #15G4 — -
Company: Expert Shutter Services -`-
City: Jensen Beach State: FL
Zip Code: 34957 Fax:
Phone No.630-379-6774
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
u vaiue or consirucrion is pzouu or more, a ntcoeutu Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW.INFORMATIONc..i
.' r
DESIGNER/ENGINEER:
Name: Tiuecoma
_ Not Applicable
MORTGAGE COMPANY: X
Name:
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: _Not
Name:
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 youjntend to obtain financing, consult with lento an attorne0efore
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF51—LA_3_C tC COUNTYOF_C:�-k— IAACa C
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thl� day of �-C�YL.t_C4-,4 20 i1by this:2(�pday of T::P�n 1 20 t � by
Michael Heissent>t?tg Michael Hsissenberg
(Name of person acknowledging) (Name of person acknowledging )
otary
of Nodary Public- State
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced— �I Type of Identification Produced
Commission Nor C C� I�^�t Y Z (Seal)— Commission No:�- (Seal) _ _ _--
'%R NOTARYPLIG iC �pi sf Haleigh Short
�-
Revised 07/15/2014
Comm# GG148342
Fvnirpc R/9Fi9n91
GG148342
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