HomeMy WebLinkAboutBUIDLING PERMIT APPLICATIONf=
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED o
Date: SCANNED Permit Number: / 0�� ' 053D
BY
Nry St. Lucie County REcei�E�
Building Permit Application o10�e
Planning and Development Services eFa�R,en
Building and Code Regulation Division cet,aoo ��e Coo°�
2300 Virginia Avenue, Fort Pierce FL 34982 St
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x Residential
PERMIT APPLICATION FOR: Shutter I
Address: 7410 S Ocean Dr#505
Legal Description: SAND DOLLAR VILLAS CONDOMINIUM D- UNIT 505 AND UND PRO-RATA SHAREIN COMMON ELEMENTS
Property Tax ID #: 3522-605-0024-000-3
Site Plan Name:
Project Name: Keysor
Setbacks Front Back:
Install 1 Accordion shutter
Right Side:
HVAC I l Gas Tank UGas Piping
Electric 0 Plumbing []Sprinklers
Total Sq. Ft of Construction: _
Cost of Construction: $ 754.00
Lot No.
Block No.
Left Side: x
Shutters Windows/Doors
Generator 0 Roof = Roof pitch
S Ft. of First Floor: _
Utilities: Sewer 0 Septic
Building Height:
WyR%LiSEEy
CONTRACTOR =M
Name Harold Keysor
Name: Michael Heissenberg
Address: 7410 S Ocean or #505
Company: Expert Shutter Services
City: Jensen Beach State: FL
Zip Code: 34957 Fax:
Phone No.410-499-1043
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
It value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL,CONSTFiUCTION,LIEN.LAW lNf ORNIATION;',_ .
>r •. F
DESIGNER/ENGINEER: _
Name: Tiltecolnc.
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: x
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 inspection. If yoty�intend to obtain financing, consult with lender or an attorney before
STATE OF FLORIDA STATE OF FLORIDA
COUNTYOFf2l, 1 ii 1(;-e COUNTY OF zj1 "xra2
The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this ldayof)\A%lj 20by this�dayof �la�\ 20 A9,by
Michael Heissenb,4g Michael Hsissenberg
(Name of person acknowledging) (Name of person acknowledging )
Personally Known v OR Produced Identification
Type of Identification Produced
Commission No. eG LEN2- (Seal)
tARYa,_ r Iaeigh Short
Revised07/15/2014 0( rr �STATE OFFLORIDA
q Comm# GG148342
of 4ta4y Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
CommissionNo.r--,(=i (q &3y2 (Seal)
aoSARR 4. Haieign ohort
b iATE OF FLORIDi
Comm#GG148342
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