HomeMy WebLinkAboutBuilding Permit Application ALL APPLI ABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �/ Permit Number:
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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 11VIPROVEMENT LOCATION
Address: 9960 S OCEAN DR 805
Legal Description: THE MIRAMAR II UNIT 805
Property Tax ID#: 4502-702-0035-000-2 Lot No.
Site Plan Name: Michael Lagala Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIjPTIONOF:WORK
Install 1 Accordion shutter
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Additional
INFORMATION
itiona work to be nertormed under this permit—check all appy:
HVAC Gas Tank []Gas Piping 1( Shutters 11
Windows/Doors
Electric 0 Plumbing Sprinklers EiGenerator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 1450.00 Utilities. Septic Building Height: 200'
rCO NTRACTO R a '
OWNER LESSEE r
n�.
b t sar t
Name Michael Lagala Name: Michael Heissenberg
Address:9960 S Ocean Dr#805 Company: Expert Shutter Services
City: Jensen Beach State:FL. Address: 1626 SW Biltmore St
Zip Code: 34947 Fax: City: Port St Lucie State:FL
Phone No.772-229-3395 Zip Code: 34984 Fax:
E-Mail: Phone No. 772-871-1915
Fill in fee simple Title Holder on next page(if different E-Mail: callexpert@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.
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St1 �L :SAL CONSTICTION LIEN LAIN INF4
EMENRMATION �
DESIGNER/ENGINEER: X_Not Applicable MORTGAGE COMPANY: _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 yo inten obtain financing, consult with lender or an attorney efore
commencingwork or di our Nice of Commencement.
s
_Signature of Owner/Lessee/Agent Signalure of Contractor/License Hold
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF St Lucie COUNTY OF St Lucie
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20(�Cby this >0 day of 20( �C by
Michael Heissenbi�g Michael Heissenberg
(Name of person ack wledging (Name of peron acknowledging)
` L)to)
(Signature of Notary Public-State of Flor' (Signature of Not Public-State of FI (a )
Personally Known x O �roducWdentification Personally Known x OR Produced Identification
Type of Identification Pro THEIR VIZZO Type of Identification Produce ER
W/wtslle
PUBLIC °o NOTARY PUBLIC
Commission No. 'TAT-49F FLORIDA Commission No. =S1 �E, FLORIDA
Canm#FF176266 Comm#FF176266
Expires s�HC 10
18
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
I N ITIALS