HomeMy WebLinkAboutBuilding Permit Application ALL APPLICARII E INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (�
Date: Permit Number: V / " 04
Building Permit Application RECEIVED
Planning and Development Services SEP 2 5 2015
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
a
Address: 3113 Ocelot Way
Legal Description: RIVERSIDE AT SANDS BLDG 30 UNIT 5
Property Tax ID#: 1426-502-0023-000-9 Lot No.
Site Plan Name: Joan R Bassoff Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
Install 2 accordion shutters
Ilk Z�
itiWnato ee Orme uWderffis ermit—c ec a appy:
❑HVAC GasTank as Piping Shutters F]Windows/Doors
❑Electric 0 Plumbing ❑Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 4,995.00 WO� Utilities: Sewer[]Septic Building Height:
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Name Joan R Bassoff Name: Michael Heissenberg
Address:3113 Ocelot Way Company: Expert Shutter Services
City:
Fort Pierce State:FL Address: 1626 SW Biltmore St
Zip Code:
34949 Fax: City: Port St Lucie State:FL
Phone No.772-595-9557 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.
DESIGNER/ENGINEER: j Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: 1 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-c-onsideration-of-the granting- this requested ermit;I do-hereby-agree-that-l- res ects- perform the-work --
- g g 9 P � respects-,-
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 inspecti . you intend to qbtain financing, consult with lender or an attorney before
commencing work or re r In ur Notiq6of Commencement.
'"' //4-.- "-o
S .
_Signature of Owner/Lessee/Agent Signature of Contracto Lic e H der-
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF stUde COUNTY OF slLude
The fnrgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thig9laclay of FIs`Q+ 20 ! .by this Zs'Way of 5'�e4 ,20 (,S'by
Michael Heissenb�g Michael Heissenberg
(Na of per n acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Flori (Signature of Notary Public-State of Flor )
Personally Known x OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Produced Type of Identification Produced
HEATHER VIZZO THER VIZZO
Commission No. ARY pUBUC Commission No.
TARY PUBLIC
STATE OF FLORIDA a Ed STATE OF FLORIDA
ConwW 1
Revised 07/15/2014 t Expires 11/13/2018 ` Expires 11/13/2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS