HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dater" 2�t4T�, Permit Number: 11G4 a— 41—(1
RECEi'.'-:D FEB 10 2016
1117, 1A
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
PR0PQSIED IMPROV/ MENT,LOCATtf `" �'
Address: 10102 S. Ocean Dr#602 Jensen Beach, FL 34957
Legal Description: ATLANTIS CONDOMINIUM BLDG A UNIT602A AND PRO-RATA SHARE IN COMMON ELEMENTS
Property Tax ID#: 4502-802-0049-000-0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DEVILED DESCRI(' 'I`O-7- WQRK:
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Installation of one (1) rolling shutter, crank operated.
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Additional work toa nertormed under this permit—check all appy:
HVAC E:]GasTank E]Gas Piping Shutters ❑Windows/Doors .
Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ 1,926.00 UtilitiesInSewer Septic Building Height: 70'
OW( ERf IESSE;E
� x CONTRACTOR:
s:
Name Blick,Betty Name: Michael Heissenberg
Address: 10102 S. Ocean Dr#602 Company: Expert Shutter Services, Inc.
City: Jensen Beach State:FL Address: 1626 S.W. Biltmore St.
Zip Code: 34957 Fax: City: Port St. Lucie State:FL
Phone No.772-229-2164 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.
SIJPF fEiTAL� 4�jtICTlC HIEN I1NylN' �1015*NNINII
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Tiiteco,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 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 work oc_pe4;qrding your Wtice of Commencement.
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_Sig ature of OwnerrLessee/AgentSignature of Contractor/License Holde
elf
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The r.oing instru ent was acknowledged before me The forgoing instrume�it1 was acknowledged before me
this day of (�.iCl� 20 Eby this '—' day of ��J(i..(Qr' 20 w by
j'c �� i+ -I �l 1 S.�C terra ,'
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary`Pubo c-State of FI ria (Signature of Notary P7OR
State of FI ri a)
PersonallyKnown V OR Produced Identification Personally Known Produced Identification
Y
Type of Identification Produced Type of Identification Produced
(' (�( At. MY Commission NXT 17 by � HEATHER VIzzOCommission NOMI- �7 1� � RYPUBLIC
NOTARY PUBLIC S A E OF FLORIDA
STATE OF FLORID Comm#FF176266
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Revised 07/15/2014
Expires 11/13/2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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INITIALS