HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED il
Date: ��I1 l5 Permit Number:
L RECEIVED AUG 112015
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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
PROPOSED I IVI PROVEIVI ENT. LOCATION:
Address: 4949 N AIA Apt 82
Legal Description: BREAKERS LANDING UNIT 82
Property Tax ID#: 1414-602-0022-000-2 Lot No.
Site Plan Name: David W Rice Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED.DESCRIPTION`OF WORK:'''
Install 3 Accordion shutters
CONSTRUCTION fNFORMATION.
Additional work to be nertormed under this permit—check all appy:
HVAC E Gas TankGas Piping �Shutters Q Windows/Doors
Electric ❑Plumbing Sprinklers MGenerator Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 2830.00 Utilities: Sewer Septic Building Height. 30'
01NNER/LESSEE: CONTRACTOR. .
Name David W Rice Name: Michael Heissenberg
Address:4949 N A1A Apt 82 Company: Expert Shutter Services
City: Fort Pierce State:FIL Address: 1626 SW Biltmore St
Zip Code: 34949 Fax: City: Port St Lucie State:FL
Phone No.772-466-5531 Zip Code: 34984 Fax:
E-Mail: Phone No. 772-871-1915
Fill in fee simple Title Holder on next page(if different E-Mail: expertpermits@aol.com
from the Owner listed above) State or County License: 16572
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: X 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 inspectio u intend to tain financing, consult with lender or an attorney befor
commencingwor o ordi r NotW of Commencement.
s
_Signature of Owner/Lessee/Agent Signature of Contractor/Licens° older
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF St Lucie COUNTY OF St Lucle
The forgoing instru ent was acknowledged b fore me The forgoing instrument was acknowledged before me
this q*Vdayof w,s 201 by this��►1dayof .rs+ 20 j by
Michael HeissenbAM Michael Heissenberg
(Name of person a nowledging) (NaVoTfper on acknowledging)
(Signature of Notary Public-State of Flori Ua 61 (Signature of Notary Public-State of Yidaiv
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
tt�R1' HEATHER VIZZO
Commission No. NOTf�(IpUBLIC Commission No. NOTAR`�` IC
-+STATE OF FLORIDA
�Comm#FF176266 0 -�STATE OF FLORIDA
4' E 19� Expires 11/13/2018 'INCE 1
Revised 07/15/2014 11q Expires 11/13/201$
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA.TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS