HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date6'y 1 �� Permit Number:
RECEIVED APR 0 7 2016
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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 - Con a
PROPO D �11/IrPROVEMENT LOCATIQN
Address: 9960 S OCEAN DR 1601
Legal Description: THE MIRAMAR II UNIT 1601 .
Property Tax ID#: 4502-702-0066-000-8 Lot No.
Site Plan Name: Deani H Campo Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
D TAILEDfC)E CIZI -TI' WOF WORK k
4
Install 1 Accordion Shutters
fi
itiona wor�'to e e orme un er this permit—check all UWapply:
❑HVAC Gas Tank Gas Piping _Shutters Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 8850.00 Utilities: Sewer 0 Septic Building Height: 200
Name Deani H Campo Name: Michael Heissenberg
Address:907 Main St Company: Expert Shutters
City: Port Jefferson State:NY Address: 1626 SW Biltmore St
Zip Code: 11777 Fax: City: Port St Lucie State:FL
Phone No.772-229-3667 Zip Code: 34984 Fax:
E-Mail: Phone No. 772-871-1915
Fill 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.
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SUPPLEMENTALrQONSTRtJCTION LIEiV LAW 1NE0RMATION
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: X-NotApplicable
Name: Waiterriiiit 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 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 intend to obtain financing, consult with lender or an attorney before
commencing work or-recordjjag your No ' e of Commencement.
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_Signature of Owner essee Agent Signature of Contra ctor/Lilcenseolder
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STATE OF FLORIDA I STATE OF FLORIDA / Ca
COUNTY OF � C COUNTY OF l/�
Th fooing instr e t acknowledge before me The fgrgoing instru e t acknowledged before me
thi 'day of 20
before
thi�`�i day of 20 by
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(Name of person acknowledging (Name of person acknowled ing)
(Signature of Notary Pub c-State of Flori ) (Signature of Notary Pub c State FI ri i
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
(' �1�,,1,,„ HEATHER VIZZO o ER VIZZO
Commission NiS -t' +��✓'v� o.��AY ')NOTARY PUBLIC Commission I ��`�` g�Y 4ss T
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—STATE OF FLORI A �STATE OF FLORIDA
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Revised 07/15/2014 s�ryt:ele��' Expires 11/13/2018 e1 � Expires 11/13/2018
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