HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: )^cu' QI
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Shutter
I?ROPQSEP,,],MPROVEMENT LOCATION
Address: 9600 S Ocean Dr#1205
Legal Description: EMPRESS CONDOMINIUM UNIT 1205
Property Tax ID#: 4502-620-0095-000-9 Lot No.
Site Plan Name: Block No.
Project Name: Bruce D Williams
Setbacks Front Back: Right Side: Left Side:
DETAILED DE'SCRIPTION`"OF WORK
Install 1 Accordion shutter
CONSTRUCTION INFORM"ATION r
Additional work to be nertormed under this permit—c ec k a appy:
HVAC Gas Tank []Gas Piping V/ Shutters []Windows/Doors
Electric 0 Plumbing ❑Sprinklers [Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction: $ 3074.00 Utilities:cn Sewer E]Septic Building Height:
OWNER/LESSEE CONTRACTOR
Name Bruce D Williams Name: Michael Heissenberg
Address:9600 S Ocean Dr#1205 Company: Expert Shutter Services
City: Jensen Beach State:FL Address: 1626 SW Biltmore St
Zip Code: 34957 Fax: City: Port St Lucie State:FL
Phone No.772-229-1437 Zip Code: 34984 Fax:
E-Mail: Phone No. 772-871-1915
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION
DESIGNER/ENGINEER: x—Not Applicable MORTGAGE COMPANY: XX Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: x Not Applicable
Name: 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 thepermit 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 int nd to obtain financing, consult with lender or an attorney before
commencing work re ding yoXr Notice of Commencement.
/ s
—Signature of Owner/Lessee/AgElOt Signature of C ntractor License H der
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF St Lucie COUNTY OF StLucle
The forgoing instrument was acknowledged bVfore me The forgoing instrument was acknowledged before me
this day of W�ocd 20 _by this day of "7 20 11 C by
Michael Heissenb&g Michael Heissenberg
(Name of person acknowledgi
ng) (Name of person acknowledging)
t�� �
(Signature of Notary Public-State o F o I ) (Signature of Notary Public-State r'da)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. EIR VO BC Commission No. ifs HHEVHER VIZZO
NOT YPU
c -IV6 ARY PUBLIC
STATE OF FLORIDA STATE OF FLORIDA
Comm#FF176266Win.—FF1 76266
Revised 07/15/2014 s� i9�e Expires 1111312018 Expires 11/13!3018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS