HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED j lQ
Date: 11/18/15 Permit Number:
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
PCPC3`SJD1lI�=RDMENTs OATIC # ry .; , . y
Address: 9550 S Ocean DR Apt 1406,Jensen Beach, FL 34957
Legal Description: ISLANDIA I CONDOMINIUM UNIT 1406 (OR 3609-2532)
Property Tax ID#: 4502-601-0130-000-8 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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te r.� x ms's+y t
• "'Installation of of one (1) accordion shutter.
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Additional work toe nertormed under tispermit—check all appy:
HVAC Gas Tank Gas
Piping � Shutters n� Windows/DoorsDoors
11 Electric ❑ Plumbing Sprinklers _ enerator
1:1 Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 6461.00 Utilities:]Sewer 0Septic Building Height:
oitlRs � r21 IN
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_ . ..•.. . r <. ;. �g .r . .a..�
Name Lamont T Pinker Rosanne Pinker Name: Michael Heissenberg
Address:28 Virginia Ave Company: Expert Shutter Services, Inc.
City: Binghamton State:NY Address: 1626 S.W. Biltmore St.
Zip Code: 13905 Fax: City: Port St. Lucie State:FL
Phone No.607-727-3990 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: Tiiteco,ino. Name:
Address:6355 N.W.36th St.Suite 305 Address:
city: Miami State: Ft. 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 recording your Wtice of Commencement.
IZZIZZ7LI s
_Signature of Owner/Lessee/Agent Signature of Contractor/License Hold r
STATE OF FLORIDA ��` �� � ��� STATE OF FLORIDA � /U��s'
COUNTY OF COUNTY OF
The fooing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this I �day of /1,1Q 20by this = day of lA((1' 20 by
►'Syob2I- 1M1 i ChN -R i nab
(Name of person acknowledging) (Name of person acknowledging)
(Signature of NotaryPu lic-State of FI-r' (Signature of Notary P lic-State ida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification ProducedII Type of Identification Produced
Commission No1� LA a _ ) HEATHER VIZZC Commission Noff I � ( t}iER VIZZO
t o� NOTARY PUBLIC o NOTARY PUBLIC
+STATE OF FLORIDA cr °W". A.TF OF FLORIDA
:e Comm#FF17 °C ,��Copm#FF176266
Revised 07/15/2014 I AS11 Expires 11/13/2018
'ri _t'g Expires 11/1312018
� CE 19
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS