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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED Permit Number:
01111111kBY
St. Lucie County DELVED
® Building Permit Application DEC .04 74rq
Planning and Development Services PeRNttiog DePartm
Building and Code Regulation Division St. Lucie ep rtren•.,
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x Residential
PERMIT APPLICATION FOR: Shutter III
Address: 10410 S Ocean or #1001
Legal Description: HUTCHINSON ISLAND CLUB -APT 1001
Property Tax ID #: 4511-514-0073-000-1
Site Plan Name:
Project Name: Yelcich
Setbacks Front Back: x Right Side: Left Side:
Install 1 Accordion Shutter
LJ Gas Tank
El Plumbing
Total Sq. Ft of Construction: _
Cost of Construction: $ 2,046.00
Lot No.
Block No.
imspermit — cneCKan tnat apply:
[]Gas Piping t1 Shutters ❑ Windows/Doors
Sprinklers Generator 11 Roof = Roof pitch
S Ft. of First Floor:
Utilities:SewerE]Septic Building Height:
9
Name Barbara Yelcich
Name: Michael Heissenberg
Address:1220 Bay Ridge PKWY
Company: Expert Shutter Services
City: Brooklyn State: NY
Zip Code: 11228 Fax:
Phone No.917-789-3202
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
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
y5l1PPLEIVIENTAL0IVSTRUCTtOtV>L"I is sL°AU4t 1riookMATI`0(V
DESIGNER/ENGINEER:
Name: Thlteminc.
_ Not Applicable
MORTGAGE COMPANY:
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:
X 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 post9d on the jobsite
before the first inspection. If you iAtend to obtain financing, consult vtitM derAr an 7orney before
commencing work or r or ing v ur Notice of Commencement.
as
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF_`5-i L1J C aC COUNTY OF f'A
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this ZO day of N)Di\)CMVDGY 20 1g by this?U day of 20 1k by
Michael Heissenbir; I Michael Hsissenberg
(Name of person acknowledging) (Name of person acknowledging )
(Signature of rt1otary_Public- State of Florida ) (Signature of MMt ry Public- State of Florida )
Personally Known v OR Produced Identification Personally Known J OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. G G_7 Nii'_3 6e%%,,tlO
t A n NOTAR nF FLOR�-
Commission No. G C—i I lJ R.� / 2 (Seal)
Short
c_ UW' .- 1 NOT/Vtr
Revised 07/15/2014 ° o O 1tes 512-51202 5 STATE OF FLORIDA
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N 1�o Expire
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