HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / )w
Date: Permit Number: I S � ' ALJ
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
040,09SED IMPROVEMENT LOCATION *
Address: 4250 N AIA 604
Legal Description.. OCEAN HARBOR SOUTH BLDG A UNIT 604
Property Tax ID#: 1423-501-0044-000-0 Lot No.
Site Plan Name: Katherine A Morales Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
D'ETAI'LED'DESCRIPTION"CSF'-WORK
Install 1 Manual Roll-Up shutter
CONSTRUCTION INFORMATION
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Additional work to be performed under this permit—check a appy:
@ � a
HVAC Gas Tank ❑Gas Piping _Shutters Windows Doors
FlElectric 0 Plumbing @Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 1926.00 Utilities:Cn Sewer Septic Building Height:
OWNER/LESSEE CONTRACTOR:
Name Katherine A Morales Name: Michael Heissenberg
Address:72 Pinewood Hills Company: Expert Shutter Services
City: Longmeadow State:MA Address: 1626 SW Biltmore St
Zip Code: 01106 Fax: City: Port St Lucie State:FL
Phone No.413-237-7463 ! 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 LIEN LAW INFORMATION
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: k�.fActke o �l• Name:
Address: (0355 Nw ';b(ok- 5k 5_ ��kc- 3*ZT Address:
City: V:��•a�r C�nNp�^� State: City: State:
Zip: '153,k.ty Phone: 3o5, 311 - 51 Bo 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 inspection. If you intend to obtain financing, consult with lender or an attorney b re
commencing work our Vtice of Commencement.
S
_Signature of Owner/Lessee/Agent Signature of Contractor/Lice se Holde
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF St Lucie COUNTY OF-St Lucie
The forgoing instrument was acknowledgedbbee ore me The for oing instrument was acknowledged before me
thisl�day of �jR,ok 20 La by this ay of 20 �by
Michael Heissenb�g Michael Heissenberg
(Name of person acknowledging) (Name o erson acknowledging)
.44"� cv .0
(Signature of Notary Public-State of Florida (Signature of Notary Public-State of Florida
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. TARYPUBUC Commission No. o HEATHER 4RYPU�BLLI
`'` IC
-+STATE OF FLORIDA
o ?Comm#FF176266 o STATE OF FLORIDA
266
E eP Expires 11/13/2018 E19�q• Expires 11/1312018
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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