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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED Permit Number:
BY
RECEIVED
St, Lucie County
Building Permit Application JUN 2 8 2910
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Wcie County
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x Residential
PERMIT APPLICATION FOR: Shutter
PROP6sED?IMPROVEMENT LOCATION.
Address: 9650 S Ocean Or#1003
Legal Description: THE PRINCESS OF HUTCHINSON ISLAND UNIT 1003
Property Tax ID #: 4502-610-0093-000-4
Site Plan Name:
Project Name: Lewandowski
Setbacks Front Back: x
I Install 1 Accordion Shutter
LJHVAC II Gas Tank
IIElectric 0 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 4,319.00
Right Side: Left Side:
Peimu—uJecrc au apply:
Gas Piping �_ Shutters
Sprinklers Generator
Sat �Ft. of First Floor: _
Utilities:Sewer Septic
Lot No.
Block No.
Windows/Doors
Roof = Roof pitch
Building Height:
'OWNER/LESSEE:;
.x,
CONTRACTOR:'
Name Richard Lewandowski
Name: Michael Heissenberg
Address:4170 Woodland or
Company: Expert Shutter Services
City: Ann Arbor State:MI
Zip Code: 48103 Fax:
Phone No.734-531-7714
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
f?om the Owner listed above)
E-Mail: Callexpert@aol.com
State or County License: 16572
iT vawe oT construction is gzsuu or more, a ntmnutu Notice or Commencement is required.
Not
Name: Tlltecoinc.
MORTGAGE COMPANY: x Not Applicable
Name:
Address: 6355 Hw 36111 si suite 305 Address:
City: Virginia Gardens State: FL City: State:
Zip: 331e6 Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x 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 inten¢O,,to obtain financing, consult with lender or an attorney before
commencing work eco dins vour Notice of Commencement.
as
STATE OF FLORIDA
COUNTY OR WC s-e
The forgoing instrument was acknowledged before me
thisday of �I-Aj . , 20 $by
STATE OF FLORIDA
COUNTY OF ^—,+ L A Lo c
The forgoing instrument was acknowledged before me
this A'!�L day of 3\-Xn . 20 —a by
Michael Heissenbirg Michael Hsissenberg
(Name of person acknowledging) (Name of person acknowledging )
(Signature bflNotary Pubbllic-State of Florida) (Signature oT tary Public- State of Florida )
Personally Known J OR Produced Identification Personally Known `// OR Produced Identification
Type of Identification Produced Type of Identification Produced
aptPRYq& .+aieign Jnort
Commission No. �21! �% c� of NOTARY PUBLI ommission Noc—IGI � c'�,Z (Seal)
c oSTATEOFFL0 IDA
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Revised 07/15/2014 & CE 1Fb Expires 5/25/2021 �� 09 NOTARypUBLIC
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