HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: o' 1J ' J Permit Number: )1 D od I
RECEIVED
Building Permit Application AUGPlanning and Development Services A 13 1015
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Shutter
PROPOSED IIVI"PROVEMENT LOCATION
Address: 1131 Nettles Blvd
Legal Description: ISLAND CREST CONCOMINIUM UNIT 810
Property Tax ID#: 4502-501-1318-000-0 Lot No.
Site Plan Name: Gloria Pulley Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
D'ETAlLED°DE$CRIPTION,
;OF 1NORK . , . .
Install 1 Accordion shutter
CONSTRUCTLON INFORIVIATlON
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Additionalwork to be nertormed under this permit—check a appy:
HVAC Gas Tank Gas Piping � Shutters ❑Windows/Doors
❑Electric ❑ Plumbing ❑Sprinklers OGenerator Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 1070.00 Utilities:Sewer Eheptic Building Height:
OWNER/LESSEE: CONTRACTOR p °
Name Gloria Pulley Name: Michael Heissenberg
Address:.1131 Nettles Blvd 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.772-229-6140 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.
Y
S(JPPLEMENI'ALCONSTRiUCTION LIErN LAW INFORIVI,4TIONtaMv
.... .. . .. . n
DESIGNER/ENGINEER: x 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 inspection. If you inte d to obtain financing, consult with lender or an attorn y before
commencing work or or&pg youy/Notice of Commencement.
V
s
_Signature of Owner/Lessee/Agent Signature of Co tracto/License H er
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S«uC1e COUNTY OF SI Lucie
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thisQay of 2011�by this/ day of 20 I�by
Michael Heissenb&g Michael Heissenberg
(Name of person acknowledging) (Name of person ackn wledging)
(Signature of Notary Public-State of Flol a (Signature of Notary Public-State of Flo(#)
)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
*01
H T R VIZZO
Commission No. � NOTM@yffUBLIC Commission No. t '� N PUBLIC
STATE OF FLORIDA STATE OF FLORIDA
m#FF176266Expires 11/13/2018FF 176266
Revised 07/15/2014 ae to a Expires 11/13/2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS