HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: '�'�`�l�� Permit Number:
R C11'rD APR 07 2016
Buil Ing 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
PRPOSEt),lN1PROVEMENT LQCATItN „ y x.,: X
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Address: 4160 N Highway Ala Apt 403 A
Legal Description: OCEANIQUE OCEANFRONT(OR 2752-1842)BLDG A UNIT 403
Property Tax ID#: 1423-506-0017-000-7 Lot No.
Site Plan Name: George R Zerdian Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DTAILDCt1PTNtWORK
DESIO
Install 1 Roll Up Shutters ��:zoo
CQNSTRUCTION r
ATtNFORMION M
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Additional work to lie nertormed under this permit—check a pp y:
HVAC Gas Tank E]Gas Piping _Shutters ❑Windows/Doors
❑Electric ❑Plumbing Sprinklers ❑Generator ❑ Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 1615.00 Utilities: Sewer Septic Building Height: 140
r
0lNNER/LESSEE CONTRACTCOR ' -a
Name George R Zerdian Name: Michael Heissenberg
Address:4160 N Highway Ala Apt 403A Company: Expert Shutters
City: Fort Pierce State:FL Address: 1626 SW Biltmore St
Zip Code: 34949 Fax: City: Port St Lucie State:FL
Phone No.772-475-0181 Zip Code: 34984 Fax:
E-Mail: Phone No. 772-871-1915
FIII in fee simple Title Holder on next page(if different E-Mail:
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.
SUPPLEMElNITAL W NSTRl1CTI0N LIEN LAW {N[=ORMATION
F :s
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DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: waiterTiilit Name:
Address:6355 NW 36th St Address:
City: Virginia Gardens State: FL City: State:
Zip: 33168 Phone: 305-871-1530 Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x 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 ol-xPacording your N .tice of Commencement.
_ — s
_Signature of Owner/Lessee/Agent Signature of Contractor/Liccense of er
STATE OF FLORIDA �T j f /J+ (� STATE OF FLORIDA J I i / Cl�
COUNTY OF .l 1 C, COUNTY OF L�Vl
The for� oing instr e �was acknowledgId before me The for, going instru ent as acknowledged before me
this day of /J i 20 kD by this day of t 20 by
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(Name of person acknowledging J (Name of person acknowledging)
I/ t
YA j
(Signature of Notary 711
State of Florida) (Signature of Notary
7_011
State of Flo r' a)
P uced Identification Personally Known Produced Identification
Personally Known Produced
Type of Identification Produced
Type of Identification Produced YP
ot�Y4s HEATHER V ZZO � I / I V HEATHER VI
Commission N00 1 10� so,NOTARY PU acmmission lG 10 ro
c o `NOTARY PU IL
a -STATE OFF ORIDA
. o o STATE OF FL0 DA
S��dCE 19Expires 11/13/2018 s�yQE 19'►e omm#FF17626
Revised 07/15/2014 Expires 11/13/3018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS