HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONJ
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �}
Date: 'SCANNED Permit Number:
Y
BY
® � 54. Lucie County
Building Permit Application RECEIVED
Planning and Development Services APR 16 2019
Building and Code Regulation Division Permitting oepe
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie Counpy9nt
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Shutter
Address: 5051 N HIGHWAY A1A 12-4
Legal Description: SEAWARD AT ATLANTIC VIEW UNIT 12-4
PropertyTax ID #: 1414-612-0062-000-5
Site Plan Name:
Project Name: Bilik
Setbacks Front Back: X
Install 1 accordion shutter
❑HVAC
❑ Electric
❑ Plumbing
Right Side: Left Side:
Lot No.
Block No.
❑ Windows/Doors
❑ Roof = Roof pitch
Total Sq. Ft of Construction: Sc FFtt.� of First Floor:
Cost of Construction: $1D,-115.00 Utilities: Sewer ❑ Septic Building Height:
OWNER%LESSEE $>
GLtN ttATOR 3
Name Mary C Bilik
Name: Michael Heissenberg
Address:21963 W Pine Lake Cir
Company: Expert Shutter Services
City: Kildeer State:IL
Zip Code: 60047 Fax:
Phone No.847-337-4732
Address: 668 SW Whitmore or
City: Port Saint Lucie
Zip Code: 34984 Fax:
Phone No. 772-871-1915
State: FL
772-871-0990
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.
SUPPCEMENTAL(ONSTRUCTION'LIEN LAW
INFORMATION: µ:
DESIGNER/ENGINEER: _ Not Applicable
Name: Tllteminc.
MORTGAGE COMPANY: x
Name:
Not Applicable
Address: 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 intenoo obtain financing, consult with lender or an attorney before
as AeentAor Owner
STATE OF FLORI A STATE OF ILMA
0OUNTY OF - Luc j� COUNTY OF . I A C) C.
The for oing instrument Yvas acknowledge before me
this rdayofa—L� 20N-by
Michael Heissen4g
(Name of person acknowledging )
(Signature of Notary Public- State of Florida )
Personally Known ✓ OR Produced Identification
Type of Identification Produced 0040 Shananb'She�
NUIAM7 PUBt
Commission No.
STATE OF FL(
Commit GG25I
Revised 07/15/2014
The forgoing instrument was acknowledg,before me
this Lday of. 20 IUW— by
Michael Hsissenberg
(Name of person acknowledging )
(Signature of Notary Public- State of Florida )
Personally Known �./ OR Produced Identification
Type of Identification Produced
Sharon O'Shea
NOTARY PUBLIC
STATE OF FLORI
Expires 9/1
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