HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
D a Permit Number: \Go a_d 11 l"
" RECEIVE-D FEB 1. 0 2016
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
PRl ROSED tI IF'f�C1tEMENT-LOCATIt N` R
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Address: 10,000 S.Ocean Dr.,#204 Jensen Beach, FL 34957
Legal Description: THE MIRAMAR UNIT 204 AND PRO-RATA SHARE IN COMMON ELEMENTS
Property Tax ID#: 4502-701-0007-000-4 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCCITiCIN QF WC}RK
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Installation of one (1) accordion shutter.
C(JNSTRUCTIQU INFORMATI0N,
Additional work to be inerformed under this permit—check aappy:
❑HVAC Gas Tank ❑Gas Piping 2 Shutters Windows Doors
❑Electric ❑Plumbing Sprinklers ❑Generator ❑ Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 3,372.00 Utilities:iSewer❑Septic Building Height: 170'
01111NER/LE5SE CONTRACUR `
4
Name Robyn Tyrrell Name: Michael Heissenberg
Address: 10000 S.OceanDr.,#204 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.305-896-0710 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.
Ll LAW' 141MMME
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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 or recordiftg your Not' -of Commencement.
S
_Signature of Owner/Lessee/Agent Signature of Contract r icense Holder
STATE OF FLORIDA5� r p STATE OF FLORIDA 1 1 u C
COUNTY OF � L CIC COUNTY OF % L� i
The orgoing instr e t was acknowledged before me The forgoing instru entj was acknowledged before me
this4_z day of -(� t U OV 20 by this IE+1'day of U Cil 20 ) by
l 010'0 V14 1 5�� �er� 1 ;� � ,I �-� � �Sin
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Pu ic-State of Flor' ) (Signature of Notary Publ' State of Flor' a
Personally Known OR Produced Identification Personally Known L1/ OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission N'fS A ��0110�o -,Wr4 SeM)FATHER VIZZO Commission No`�-a�1 3 to &o pA HWMI€R VIZZO
�� �� NOTARY PUBLIC s$ NOTARY PUBLIC
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ESTATE OF FLORIDA
; ` 4e Comm#FF176266 Comm#FF176266
Revised 07/15/2014 4061W Expires 11/13/2018 m� E1 W Expires 11/13/2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
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