HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: gIa.I15 RECEI`.'-D SEP 02 2015 Permit Number: \S01-013-13
- 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 il1/IPROVEME..NT1OCATION:.
Address: 4949 N A1A 196
Legal Description: BREAKERS LANDING UNIT 196
Property Tax ID#: 1414-602-0077-000-2 Lot No.
Site Plan Name: Olimpia D'Andrea Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTI04WORK k w °�r `' " °fig
Install 2 Accordion shutters and 1 storm panel opening
CONSTRUCTION_ INFORMATION
Additionalworkto a ne orme under tis —checkermit all apply:
uGas Tank [:]Gas Piping Shutters ❑Windows Doo
rs
11 Electric ❑ Plumbing ❑Sprinklers ❑Generator ❑ Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction: $ 1816.00 Utilities:cn Sewer❑Septic Building Height: 30'
O%WNER/LESSEE `CONTRACTOR'
Name Olimpia D'Andrea Name: Michael Heissenberg
Address:11589 Edgeton Dr Company: Expert Shutter Services
City: Warren State:MI Address: 1626 SW Biltmore St
Zip Code: 48093 Fax: City: Port St Lucie State:FL
Phone No.586-668-2521 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.
SUPPLEMENTYAL CONSTRUCTION LIrEN LAW INFORMATION: l„ `i"
I b•`1
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 intend to obtain financing, consult with lender or an attorne before
commencing work or recoyouotice of Commencement.
S
—Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
CO U NTY OF St Lucie CO U NTY OF St Lucie
The J}rgoing instrumen was acknowledged b*re me The forgoing instrument was acknowledged before me
this Camay of F- 20 1 Jby this2--Dday of 20 1(1 by
Michael Heissenb&g Michael Heissenberg
(Name of person acknowledging) (Name of person acknowledging)
, ✓ f �
(Signature of Notary Public-State of ida '(Signature of Notary Public-State of lera
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. 1 HER V12ZO Commission No. t ( THER VIZZO
t�TOTARY PUBLIC NOTARY PUBLIC
STATE OF FLORIDA STATE OF FLORIDA
Com
Revised 07/15/2014 AWE tete Expires 11/13/2018 V'Nee�9� Expires 11/13/2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS