HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED )
Date: 12/8/15 Permit Number: l sla—
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
Address: 10044 S OCEAN DR 1104,JENSEN BCH, FL 34957
Legal Description: SEA WINDS CONDOMINIUM APT 1104(OR 551-64: 3415-2620)
Property Tax ID#: 4502-804-0084-000-3 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
Installation of one (1) accordion.
Additional work to be nertormed under this permit—check a appy:
HVAC Gas Tank ❑Gas Piping � Shutters ❑Windows/Doors
11 Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction:$ 1,129.00 Utilities:]Sewer 0Septic Building Height: 140'
lAddress:
ame Ilona R Dicker JR) Name: Michael Heissenberg
165 S Sewall's Point Rd Company: Expert Shutter Services, Inc.
ty: Sewall's Point State:FL Address: 1626 SW Biltmore St.
Zip Code: 34996 Fax: City: Port St Lucie State:FL
Phone No.772-219-2316 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.
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Tiiteco,Inc. Name:
Address: Address:
City: Miami State: FL City: State:
Zip: 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 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 or recording our Notice o Commencement.
Signature of Owner/Agent/Lessee Signature of Contractor/License Holder
STATE OF FLORIDAL, )L, u �
STATE OF FLORIDA 15 '
COUNTY OF �7 C( COUNTY OF . L U C 1
The ongoing instrument was acknowledged fore me Thel�f���°r�oing instru ent was a knowledged before me
this f=�day of 0Q-u(Y)b-e' 20 l'by this`1✓ �day of M iYY 20_1J by
61j,t f o l ( 4'Q I Sic A be q- 1 ' 1 ) C kw ( 1 S
(Name of person acknowledging) / (Name of person acknowledging)
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(Signature of NotaryPu c-State o r' ) (Signature of Notary 7-OR
* State FI da)
Personally Known OR Produced Identification Personally Known Produced Identification
Type of Identification Produced Type of Identification) Produced`
Commission Ncr � AR HgATHER VIZZO Commission Nff 7(p� (� al)HEATHER VIZZO
e TARY PUBLIC NOTARY PUBLIC
STATE OF FLORIDA
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Revised 07/15/2014 a Expires 11/13/2018 0 We, Expires 11/13/201
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS