HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: /s-v?-03 7 /
RECEIVED
Building Permit Application
Planning and Development Services AUG 2 5 -2015
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
PROPOSEDJMPROVEME'NT LOCATION
Address: 5406 Palmetto Dr
Legal Description: INDIAN RIVER ESTATES-UNIT 05-BLK 22 LOT 3 AND INDIAN RIVER ESTATES-UNIT 06-BLK 22 LOT 4
Property Tax ID#: 3402-606-0062-000-5 Lot No.3&4
Site Plan Name: Mark L Goodrich Block No. 22
Project Name:
Setbacks Front Back: Right Side: Left Side:
>DETAILED DESCRIPTION""()F 1IILORK.
Install 1 Storm Panel opening.
CONSTRUCTION INFORIVIATION
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zs a
Additionalwork
,toe e orme under this permit—check a apply:
❑_HVAC Ei Gas Tank Gas Piping �MGenerator
Shutters Windows Doors
Electric 0 Plumbing ❑Sprinklers Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 417.00 Utilities:cnSewer Septic Building Height:
OVIINER/LESSEE:` CONTRACTOR:.
Name Mark L Goodrich Name: Michael Heissenberg
Address:5406 Palmetto Dr Company: Expert Shutter Services
City: Ft Pierce State:FL Address: 1626 SW Biltmore St
Zip Code: 34982 Fax: City: Port St Lucie State:FL
Phone No.772-464-2237 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-CONSTftUCTIONmLI`E'N LAIN INFORMATION.`, ` "°
g
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 inspectio you intepd to obtain financing, consult with lender or an attorney Jnpfore
commencing work or rec ou otice of Commencement.
s
_Signature of Owner/Lessee/Agent Signature of Contractor/Li ense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF St Lucie COUNTY OF StLucie
The forgoing instrt was acknowledged before me The forgoing instrument was acknowledged before me
thisTW"^du en
ay of 20%r by thisZDK day of 20 1 V by
Michael Heissenb&rg Michael Heissenberg
(Name of person acknowledging) (Name of person acknowledging)
— 10
(Signature of Notary Public-State of Flo I ) (Signature of Notary Public-State or' )
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced =ATNER VIZZO Type of Identification Produced HEATHER VIZZO
NOTARY PUBLIC NOTARY PUBLIC
Commission No. TE OF FLORIDA
ATE OF FLORIDA Commission No.
Comm*FF176266 0 Comm#FF176266
B10wiFes 111131901&—
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
1626 S.W. BILTMORE ST
ESS EXPERT PORT ST LUCIE, FL 34984
SHUTTER SERVICES WC. (772) 871-1915 (800) 749-9056
"We're Taking The Shutter Industry By Storm" FAX (772) 871-0990
1ING INFORMATION DATE JOB INFORMATION
MARK GOODRICH 8/12/2015 MARK GOODRICH
5406 PALMETTO DRIVE DEVELOPMENT 5406 PALMETTO DRIVE
FORT PIERCE, FLORIDA 34982 PRIVATE HOME FORT PIERCE, FLORIDA 34982
® 772-464-2237 • OWNER
® ® - - • 00
1, 1
69'X 88" ENTRY DOORS, BRONZE, MILL PANELS $417
SPECIAL INSTRUCTIONS
TOTAL $417
SHUTTERS MEET ALL LOCAL BUILDING CODES APPROX. DELIVERY 6-8 WEEKS
FIVE YEAR WARRANTY FOR PARTS AND LABOR(SEE WARRANTY INFORMATION). DEPOSIT $139
SHUTTERS MUST BE'MAINTAINED PROPERLY(SEENAINTENANCE INFORMATION). 120
PRICE, INCLUDES,ALL MATERIAL, LABOR,INSTALLATION, BUILDING PERMIT AND TAX BALANCE $278
REPRESENTATIVE DATE PURCHASER
TOM FLAGG
WWW.EXPERTSHUTTERS.COM