HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (� t
Date: SC BN�NED Permit Number: � ` 01 • NULL
St. Lucie County
RECEIVED
Building Permit Application nil , s 7019
Planning and Development Services
Building and Code Regulation Division -" XMG: Department
2300 Virginia Avenue, Fort Pierce FL 34982 'F County
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
Address: 4206 N HIGHWAY A1A 912
Legal Description: OCEAN HARBOR SOUTH BLDG B UNIT 912 AND UND INTEREST IN COMMON ELEMENTS
Property Tax ID #: 1423-501-0164-000-7
Site Plan Name:
Project Name: O'Hare
Setbacks Front Back: X
Install 1 accordion shutter
LJHVAC LJ Gas Tank
❑Electric OPlumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 1,133.00
Right Side: Left Side:
s{permit -c ec all' apply:
]GasPipingLJShutters
]Sprinklers ❑ Generator
S Ft. of First Floor: _
Utilities:"nSewer ❑Septic
Lot No.
Block No.
❑Windows/Doors
0 Roof ❑ Roof pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Ann Marie O'Hare
Name: Michael Heissenberg
Address:2103 Frances DR
Company: Expert Shutter Services
City: Point Pleasant Boro State: NJ
Zip Code: 08742 Fax:
Phone No.732-278-9421
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 or construction is>zsuu or more, a K[LUKutu Notice of commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: -
DESIGNER/ENGINEER: _ Not Applicable
Name: Tiitecolnc.
MORTGAGE COMPANY:
Name:
X Not Applicable
Address: 6355 NW 36th StSuite 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 intend to obtain financing, consult with lender or an attorney before
commencine work or recording_ vour Notice of Commencement.
-w�� ���/fu/� s
Signature of Owner/Lessee/Con or as Agent for Owner Signature of Contractor/License F} rj r
STATE OF FLORIDA STATE OF FLORIDA ` lv
COUNTY OF Lu CI 2 COUNTY OF 5a- Lu CI -Q
The forVing instrument was acknowledged before me
this �day of t I 20 19 by
Michael
person
(Signature of Notary PP blic- State of Florio IO
Personally Known V OR Produced Identification
Type of Identification Produced
MMM/V
Commission N X'a65
Revised 07/15/2014
The forgoing instrument was acknowledged before me
this L�iay of ZT L4 I 9 2019 by
Michael Hsissenberg
( ame of person acdging )
'—)AVU-/W '�/�4�
(Signature of Notary Ppblic- State of FlodgW
Personally Known / OR Produced Identification
Type of Identification Produced
"""•.'�..,— "ram — .y°" ` ffitary Public State
GG 252657 ?'lii Heathervino
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