HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (7 (�
Date: SCANNED Permit Number: IgpLD • O19
BY
St. Luce County
RECEIVED
� • _ oma
Building Permit Application JUN io 2019
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie County
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Shutter
I PROPOSED IMPROVEMENT LOCATION:
Address: 9650 S OCEAN DR 609
Legal Description: THE PRINCESS OF HUTCHINSON ISLAND UNIT 609
Property Tax ID #: 4502-610-0059-000-4
Site Plan Name:
Project Name: Ploskonka
Setbacks Front X Back: X
DETAILED DESCRIPTION`OF WO
Install 3 Accordion Shutters
❑HVAC ❑ Gas Tank
❑Electric Plumbing
Total Total Sq. Ft of Construction:
Cost of Construction: $ 5,059.00
Right Side: Left Side:
nu—uicLn do dppry:
Piping V Shutters
=rs ❑ Generator
S Ft. of First Floor: _
Utilities:n Sewer ❑ Septic
Lot No.
Block No.
❑ Windows/Doors
❑ Roof ❑ Roof pitch
Building Height:
OW N ER/LESSEE:~ I
CONTRACTOR:
Name Frank Ploskonka
Name: Michael Heissenberg
Address: 9650 S Ocean DR Apt 609
Company: Expert Shutter Services
City: Jensen Beach State: FL
Zip Code: 34957 Fax:
Phone No.734-788-4416
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
o varue or consrrucnon is ?zbuu or more, a HtcuRutui Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION'LIEN,LAW INFORMATION'
DESIGNER/ENGINEER: _ Not Applicable
Name: Tiltecolne.
MORTGAGE COMPANY: x Not Applicable
Name:
Add ress: 6355 NW 36th St suite 305
Address:
City: Virginia Gardens State: Ft
Zip: 3316e Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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 inspect!If you inten obtain financing, consult with lender er�an attorney before
commencing work or ecor ira vo-ur ice of Commencement._ 7 l --., it
as
STATE OF FLORIDA STATE OF FLO I A
COUNTY OF ie COUNTYOF 1_U�iP
The for oing instrum t was acknowledge before me The forgoing instrument was acknowledgeefore me
this day of)�, 20 by this _L day of "fore
20 a by
Michael HeissenbI6 Michael Hsissenberg
(Name of person acknowledging) (Name of person acknowledging)
U&*k 0' �I,.� () L t A
(Signature of Notary Public -State of Florida) (Signature of Notary Public -State of Florida )
Personally Known -./ OR Produced Identification _
Type of Identification Produced_
shnnnn O'1
Commission N �4�. 6y l NOTARY P
'_T ) S STATE OF
`.>_=Comm#GG
Personally Known OR Produced Identification
Type of Identification Produced
106mmission NKA>ZQ6b3Z ptARY eal$hanon O'Shea
38_ ,y�, NOTARY PUBLIC
Revised 07/15/2014 !:s 0 Comm# GG258038
�YCE l Expires 9/12/2022
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