HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:-J44140105"'S ��� Permit Number: `(DO3_001G
tv RECE1' - PEAR 04 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
PROP{ ED�INPR }UEN[E,tTL®CATIM�U
Address: 10200 S. Ocean Dr.,#502 Jensen Beach, FL 34957
Legal Description: ATLANTIS III BY THE SEA UNIT 502AND PRO-RATA SHARE IN COMMON ELEMENTS
Property Tax ID#: 4511-518-0040-000-3 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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Ll� ALtr_1.7I.i L. 11 �1�11�yM rRl��''� e d fwd-ham EE RIIt ,.
Installation of four (4) accordion shutters.
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Additionalwork toe e Orme under this permit—c ec a appy:
HVAC E] Gas Tank ❑Gas Piping Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S3,149.00 Ft. of First Floor:
Cost of Construction:$ Utilities:'n Sewer[]Septic Building Height: 70
0111NERjLESSE £ k V - wCON7RACTOR ;y� E
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Name Richard C Radko Ellen C Radko Name: Michael Heissenberg
Address:11 Salisbury Rd Company: Expert Shutter Services, Inc.
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City: Delmar State:NY Address: 1626 S.W. Biltmore St.
Zip Code: 12054 Fax: City: Port St. Lucie State:FL
Phone No.518-577-0658 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.
Sl1FP ElUi NTA C�NSTRUC'TlC�?N I.I i ,J:MAVY INF RMATlO
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 re co_d> ng yourNotice of Commencement.
S
_Signature of Owner/Lessee/Agent Signature of Contractor/License Holden
STATE OF FLORIDA r`� �_ j � � l,� STATE OF FLORIDA �� � `� n,
COUNTY OF �}'T (� COUNTY OF ( /
The oygoin instrument as acknowledged before me Th ,0oing instr n w s acknowledged before me
this 1 sd day o 1 20 1'6b y thi — day of_ ����- 20 L 10 by
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(Na a of person acknowledging) (Name of person acknowledging)
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(Signature of Notary P lic-State of FI ri a (Signature of Notary P blic-State of Flo d
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
� t(aRVgs HEATHER VIZZO 1� w HEATHER VIZZO
Commission so( ARYPUBLIC Commission No 1 �� NOTJPUBLIC
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'---'STATE OF FLORIDA
a STATE OF FLORIDA
Revised 07/15/2014 Expires 11/13/2018 ifs¢190 Expires 11/13/2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS