HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: /so 9.
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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 I.MPROVEIVImENT LOCATION re
Address: 3150 N A1A 1002
Legal Description: TIARA TOWERS UNIT 1002-N
Property Tax ID#: 1425-610-0045-000-8 Lot No.
Site Plan Name: Jean C Simmons Block No. -
Project Name:
Setbacks Front Back: Right Side: Left Side:
L7ETAI'LED, E$CRIPTION'117 F,WORK ` '
Install 1 Accordion shutter
CONSTRUCTION INFORNATIO.N
Additional work to be nertorme under tis permit-c check appy: .
HVAC Gas Tank Gas Piping _Shutters Windows Doors
❑ ❑
❑Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 459.00 Utilities:n Sewer E]Septic Building Height: 150'
OUVN ER/LESSEE CONTRACTOR:
, .:
Name Jean C Simmons Name: Michael Heissenberg
Address:3150 N A1A 1002 Company: Expert Shutter Services
City: Ft Pierce State:FL Address: 1626 SW Biltmore St
Zip Code: 34949 Fax: City: Port St Lucie State:FL
Phone No.626-222-3794 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: Wkkke �+ �� Name:
Address: (0316 Z.k- 5—Ac. 30< Address:
City: V4!s ;0k Gi..ne...5 State: f:t- City: State:
Zip:- '3-6i ta(v Phone: '305'- 93 t- 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 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 intemd to obtain financing, consult with lender or an attorney b ore
commencing work or rec in o Notice of Commencement.
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Signature of Owner/Lessee/ t Signature of Contractd Lic se older
g
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF St Lucie COUNTY OF scLucle
The f r oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of -!- 20 Q J by this/f�ay of per_20 Y- by
Michael Heissenb6 Michael Heissenberg
(Namperson acknowledging) (Name of pe on a owledging)
�'`� /4
(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. ,I T ER VIZZO Commission No. Y IIIEATHER VIZZO
NOT RY PUBLIC VOTARY PUBLIC
�! _STATE OF FLORIDA aSTATE OF FLORIDA
e Comm#FF17Cmm"176266
Revised 07/15/2014 �® Expires 11/13/2018 ei 1� Expires 11/13/2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
—'Sep,.4 'moi v..rr.a.-s y