HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11/18/15 Permit Number:
9 RECEIVE®
Building Permit Application Nov 2 0 2015
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
77
PRapos;EQ Ic�PRouEMEtr
Address: 3120 N A1A 101, Fort Pierce, FL 34950
Legal Description: TIARA TOWERS UNIT 101-S (OR 3740-190)
Property Tax ID#: 1425-610-0074-000-0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
D TA ED DESCRIPTION CIORK' � �
Installation of six (6) accordion shutter.
CaNSTRUCT -XIN x
Additiona I work to be ertormed under tispermit—checka appy:
HVAC Gas Tank F]Gas Piping 2 Shutters Windows/Doors
Electric ❑ Plumbing Sprinklers M Generator Roof .
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 4,011.00 UtilitiesInSewer Septic Building Height:
C}tlVl� R%LI=SvEA 7URVZ'0 :
CQ C
Name Jeffrey A Goldberg Name: Michael Heissenberg
Address: 141 SE Saddle Mountain SE DR Company: Expert Shutter Services, Inc.
City: Calhoun State:GA Address: 1626 S.W. Biltmore St.
Zip Code: 30701 Fax: City: Port St. Lucie State: FL
Phone No.772-828-3117 Zip Code: 34984 Fax: 772-871-0990
E-Mail: Phone No. 772-871-1915
Fill in fee simple Title Holder on next page(if different E-Mail: callexpert@aol.com
from the Owner listed above) State or County License: 16572
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
Sl.PPLEMENTkL CON5TI .UCTIQN L!� LA1N�NOaMA?1�3N04111
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Tilteco,inc. Name:
Address:6355 N.W.36th St.suite 305 Address:
City: Miami State: Fl_ City: State:
Zip: 33166 Phone: 305-871-1530 Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize thepermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will,in all respects, perform the work
in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing wor ecor_diM your N ice of Commencement.
s
_Signature of Owner/Lessee/Agent Signature of Contra ctor/Licen a Holder
STATE OF FLORIDA / �J STATE OF FLORIDA
COUNTY OF I�( Cr� COUNTY OF ��, uCi
The f$ming instr meot was ck o ledged before me The foTing instrument�,was cknowledged before me
this lv�day of V 20 �by this(00— day of 1 , M�l,20 ),5 by
�(Yl�►'CI Ljt( dei I r M )' Clqou A41'3cs-ma
(Name of person acknowledging J (Name of person acknowledging)
O+L�w
(Signature of Notary7OR
State of r' a) (Signature of Notary P lic-State o F r'
Personally Known Produced Identification Personally Known OR Produced Identification
Type of Identification
ll Produced
� Type of Identification Produced
Commission No t 17 WRY ( ETHER VtZZO Commission No -t lD Q6w �Aj � 1) HEATHER VIZZO
o NOTARY PUBLIC e`t' NOTARY PUBLIC
_STATE OF FLORIDA ATATP
a Comm#FF176266 '$Comm#FF176266
Revised 07/15/2014 71FRE 19�� Expires 11/13/2018 Expires 11/13/20
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS