HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: / �• �� Permit Number:
• . i RECEIVED
Building Permit Application
Planning and Development Services SEP 14 2015
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
PRO
POSE D)MPROVEMENT LQCATIQN a: .
Address: 10200 S OCEAN DR 404
Legal Description: ATLANTIS III BY THE SEA UNIT 404
Property Tax ID#: 4511-518-0032-000-4 Lot No.
Site Plan Name: Edmond C Loyot Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
Q;ETAILfD
DESCRIPTION",,,", , WORK
xi
Install 4 Accordion shutters
C41VSTRJP TC N INFORMATION
Additional workto be nertormed under tispermit—check all appy:
HVAC Gas Tank Gas Piping Shutters n Windows/Doors
L�L
0 Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 2776.00 Utilities:�Sewer Septic Building Height: 70'
OWNER/LESSEE . CONTRACTOR:
Name Edmond C Loyot Name: Michael Heissenberg
Address:2 Cowles Rd Company: Expert Shutter Services
City: Bethlehem State:CT Address: 1626 SW Biltmore St
Zip Code: 06751 Fax: City: Port St Lucie State:FL
Phone No.203-232-5633 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 CONSTRUCTION LI,E�N LAW INFORMATION:'
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: __Mk -r Name:
Address:!,-35aus%,1 3(-,k6 N- 75."hw_ ld-S Address:
City: V iy4;"0, State: fL City: State:
Zip::33,c.E. Phone:.- 0`11- 1531 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 inAnd to obtain financing, consult with lender or an attorney before
commencing wor c rcling y9fir Notice of Commencement.
c
S
_Signature of Owner/Lessee/Agent Signature of Cont ac or/Li se older
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF St Lucie COUNTY OF-St Lucie
The going instrument was acknowledged before me The forgoing instrument was acknowledged before me
this ydayof �S1LQ 200by this IT
dayof4f 20 1 Cby
Michael Heissenbtrg Michael Heissenberg
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of FI ria (Signature of Notary Public-State o Flor cj )
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. t ea*JEATHER VIZZO Commission No. tNRY (MTHER VIZ
ZO
NOTARY PUBLIC c MARY PUBLIC
C4 o�I� YgSTATE OF FLORIDA
OF F1
Revised 07/15/2014 s� ,� Comm#FF178266 `��'Cf sl Expires 11/13/2018
I E is Expires 11/13/2018 p
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