HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED , 21"
Date: 12/21/15 Permit Number:I ' 0J(II0L,
RECEIVED
Building Permit Application DEC �, 2015
Planning and Development Services
Building and Code Regulation Division
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2300 Virginia Avenue,Fort Pierce FL 34982 St, cie 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.#703 Jensen Beach, FL. 34957
Legal Description: ATLANTIS CONDOMINIUM BLDG A UNIT703A AND PRO-RATA SHARE IN COMMON ELEMENTS
Property Tax ID#: 4502-802-0060-000-3 Lot No.
Site Plan Name: Block No.
Project Name: Nataliya
Setbacks Front Back: Right Side: Left Side:
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Installation of three (3) accordion shutters.
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Additional work to e e orme un er t is permit—c ec a appy:
11HVAC Gas Tank ❑Gas Piping Shutters Windows/Doors
11 Electric Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 2,039.00 UtilitiesInSewer Septic Building Height: 70'
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Name Nataliya Muzychka Name: Michael Heissenberg
Address:60 SIR STEVENS DR Company: Expert Shutter Services, Inc.
City: Vaughan State:ON Address: 1626 SW Biltmore St.
Zip Code: L6A OH9 Fax: City: Port St Lucie State:ON
Phone No.647-800-5544 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.
S°ERPF' n. L1�114� ll�F R{V1A�TIC3:N
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 before
commencing wor r ording yourAotice of Commencement.
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Signature of Owner gent/Lessee Signa ure of Contractor/License Hold
STATE OF FLORIDASTATE OF FLORIDA f /
C/
COUNTY OF `5 ; C) COUNTY OF I L u
The forgoing instru t was acknowledged before me The forgoing instrument was ac<nowledged before me
this��day of 20 IS:by thi gday of ('f 20__E by
M11 �h CA 1 ► n 1 � Yn 1 C k6u I'55- o r
(Name of person acknowledging) (Name of person acknowledging)
V \ �
(Signature of Notary Pu lic-State of Flori (Signature of Notary Public}State of ri )
Personally Known OR Produced Identification Personally Known I//OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission NOC W- (Seal) Commission N41 7loa(O( t Flf3@��jER VIZZO
t►�Y�� HEATHER VI710 w1r.
NOTARY PUBLIC
a NOTARY PUBLIC 9
STATE OF FLORIDA
Revised 07/15/2014 0W/*CEIS
?STATE O Comm#FF176266
Comm#FF17626sExpires 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