HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED J
Date: 12/21/15 Permit Number:
Building Permit Application DEC Z. 2095
Planning and Development Services
Building and Code Regulation Division PERMITTING
2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucie County,FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Shutter
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Address: 10102 S.E. Ocean Blvd.#704 Jensen Beach, FL. 34957
Legal Description: ATLANTIS CONDOMINIUM BLDG A UNIT704A AND PRO-RATA SHARE IN COMMON ELEMENTS
Property Tax ID#: 4502-802-0061-000-0 Lot No.
Site Plan Name: Block No.
Project Name: Gorman
Setbacks Front Back: Right Side: Left Side:
Installation of one (1) accordion shutter.
A itiona wor to e e orme un er t is permit—c ec,a appy:
HVAC �Gas Tank Gas Piping �_Shutters Q Windows/Doors
Electric ❑Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: 1,438.00$ Utilities: _Sewer Septic Building Height: i
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;CONTRACTnR44i 611
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Name Lewis E Gorman III Name: Michael Heissenberg
Address:116 Garfield St Company: Expert Shutter Services, Inc.
City: Cherry Hill State:NJ Address: 1626 SW Biltmore St.
Zip Code: 08002 Fax: City: Port St Lucie State:NJ
Phone No.772-229-7978 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.
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Tilleco,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 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 int e d to obtain financing, consult with lender or an attorney before
commencing work orLe—cording yo otice of Commencement.
Signature of Owner/Agent/Lessee Signature of Contractor/License Holder
STATE F FL
COUNTYOFOFFORIDA f L / I � C I R, COUNTSTATEOY OF_ORIDA
Th forgng instr nt as a knowledg d b fore me The forgoing instr�ennt was ac<nowledged before me
th -day of _( /vl 20 by this =day of O C9 r^ 20.dby
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59A► CJ " An 1UnnI
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Publi -State of F r da (Signature of Notary Publ' -State of FI
Personally Known 7OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No1—t L 7 L D�ApMftg) HEATHER VIZZO Commission No. ) �k)U6Q%W_yA 41RTHERVIZZO
o NOTARY PUBLIC Q ° NOTARY PUBLIC
STATE OFF STATE OF FLORIDA
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Revised 07/15/2014 i eE Is1� Expires 11
Expires /13/2018018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS