HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED )
Date: �' .�J�• Z Permit Number: / s '3 op�.'1o
REcEwED
Building Permit Application AUG 2 5 1015
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 Residential X
PERMIT APPLICATION FOR: Shutter
P:Ft�POSED IIVIPROUEMENT.LCICATI. IV
Address: 6103 Balsam Dr
Legal Description: INDIAN RIVER ESTATES-UNIT 09-BLK 87 LOT 33
Property Tax ID#: 3402-610^-p0529-000-0 Lot No.33
Site Plan Name: �h. � ABlock No. 87
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED
4-K
WORK�'`` e , '
Install 1 Roll-Up Shutter
CONSTRUCTI'QN INFORNIATIO`N a .
Additionalwork toe e Orme under this permit—c ec a apply:
❑HVAC Ei Gas Tank Gas Piping �_Shutters ❑Windows/Doors
❑Electric 1:1 Plumbing []Sprinklers ❑Generator Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 846.00 Utilities:,nSewer[]Septic Building Height:
OiIVIVER/LES5'EE Ito' RACTOR
Pr.. _
. a..; tin.: n
Name �e IkA�ol cJ Name: Michael Heissenberg
Address:6103 Balsam 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.803-447-6975 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.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
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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 the permit 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 ins n. If you intenj to obtain financing, consult with lender or an attorney befor
com mending wprCor retg4ing yourNotice of Commencement.
d O s
Signature of Owner/Lessee/Agent Signat re of Contractor/Lice-nscFHolder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF St Lucie COUNTY OF St Lucie
The forgoing instrAlent was acknowledged before me The forgoing instent was acknowledged before me
this4.h,day of w s 20 11-by this;WNclay of r mv -T 20 1 -6'by
Michael Heissenb&g Michael Heissenberg
(Name; of person acknowledging) (Name of person acknowledging)
`(Signature of Notary Public-State of F&AaV (("Signature of Notary Public-State of F I
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. N96HER VIZZO Commission No. Hf IRR VIZZO
-Abk NOTARY PUBLIC NOTARY PUBLIC
W" IrF
S ARevised 07/15/2014Comm#FF176266 Comm#FF176266
'res 11113/2018 a Expires 11/13/2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
EXPERT. .
ESS
SHUTTER SERVICES INC.
we're Taking The Shutter Industry By Storm
- i
3!2-15 JOHN HAROLD
6103 BALSAM DRIVE 6103 BALSAM DRIVE
7�PORT PIERCE, FL 34982 RIVATE HOME FORT PIERCE,FL 34982
OWNER
• i
49'X 96' ENTRY DOORS,WHITE,ROIL MANUAL $846
LI/
SHUTTERS MEET ALL LOCAL BUILDING CODE _
FIVE YEAR WARRANTY FOR PARTS AND LABOR(SEE i
SHUTTERS MUST BE MAINTAINED PROPERLY E
—PLEASE A
120 — e
w
VAGH
AUL CHECKS PAYABLE TO:EXPERT SHUTTER SERVICES INC.
BUYERS RIGHT TO CANCEL"
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1626 S.W.Biltmore Street a Port St.Lucie, Florida 34984 0(772) 871-1915•(800)749-9056 Fax(772) 871-0990