HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
a e: 3 Permit Number:
RECEIVED MAR 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
PROPOSED IItl10R01fMENTt)CATIC1yN
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Address: 5155 N.A1A#612-C Ft.Pierce, FI 34949
Legal Description: OCEAN HARBOUR CONDOMINIUM C-UNIT 612 AND UNDIV SHARE IN COMMONELEMENTS
Property Tax ID#: 1411-707-0026-000-3 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
D AILEb`DE RIP3MT ON £ F, W4ORK"�s r , `° L11 J
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Installation of three (3) accordion shutters.
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Additional work toe e orme under t —checkispermit a appy:
HVAC Ei Gas Tank ❑Gas Piping 2 Shutters aWindows/Doors
Electric ❑ Plumbing Sprinklers a Generator Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ 1,681.00 Utilities:Sewer Septic Building Height: 70'
OWNERJI.ESS P ria « CONTRACTOR
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Name Jeane R Worthington Name: Michael Heissenberg
Address:840 Painted Bunting Lane Company: Expert Shutter Services, Inc.
City: Vero Beach State:FL Address: 1626 S.W. Biltmore St.
Zip Code: 32963 Fax: City: Port St. Lucie State:FL
Phone No.772 234-0249 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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IN
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 thepermit 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 intenij to obtain financing,consult with lender or an attorney before
commencingwork or recor ' our tice of Commencement.
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_Signature of Owner/Lessee/Agent Signature of Contrac or/Licen Hold
STATE OF COUNTY OF
"� L` ) >� l' STATE OF FLORIDA 3� L �/_
`.J7 (_,_, COUNTY OF 1.�1,
The for ing instrument w cknowledge before me The forgoing instr menitwas acknowledged before me
thisday of f� 20 bby this day of �tlt ��_ 20 by
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(Name of person acknowledging) ( ame of person acknowledging)
(Signature of Notary P blit-State of FI•ria (Signature of Notary P lic-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identificatiojn'Produced-
Type of Identification Produced
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Commission No t J ��C.��� (Sea Commission No� ! C� gSS HEA{ VIZZO
1{+RyAs kATHER VIZZO a� NOTARY UE3LlC
NOTARY PUBLIC -+STATE OF FLORIDA
�• s e Comm#FF176266
Revised 07/15/2014 Comm#FF176266 E I Expires 11/13/2018
El9► Expires 11/13/2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS