HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �1
Date: ����1 ��P Permit Number:
W.
ECE " D APR 182016
a � �
BUN ng ermlt 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 _ Residential
PERMIT APPLICATION FOR: Shutter
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Address: Lit o 0
Legal Description: �r-Gp�S..vE.
Property Tax ID#: x'-123- 'so'Z - I�' ��� Cp Lot No.
Site Plan Name: T__"y1"- Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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Additional work toe e orme un er this permit-check a appy:
HVAC 11 Gas Tank ❑Gas Piping V Shutters ❑Windows/Doors
❑Electric ❑ Plumbing 11 Sprinklers ❑Generator ❑ Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ Q 1 3 Z Utilities: _Sewer❑Septic Building Height: i1liftiza,
Namek- VkcU&A Name: Michael Heissenberg
Address: 061o% Oty Company: Expert Shutters
City: State: 'Ft- Address: 1626 SW Biltmore St
Zip Code: - 364 0S5 Fax: City: Port St Lucie State:FL
Phone No. !TIP I - 6'1`��' (olo I 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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DESIGNER/ENGINEER: 0 Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: waiterTiliit 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 BOLDER: 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 in nd to obtain financing, consult with lender or an attorney before
commencing wor ecording VWr Notice of Commencement.
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_Signature of 0 r/Lessee/Agent Signature of Contractor/License Her
STATE OF FLORIDA (�� STATECOUNTY OF FLORIDA
'COUNTY OF •J�
The fo oing instru a was acknowledged before me The for �ing instrument was acknowledge before me
this 15_"day of (� 20�by this L 'day of 20 [L by
nn �Ckcw SsPnarc _fin �'C l�� i 4Af S S-Pn b-&c I
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(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Pub[' -State of or' a) (Signature of Notary Pu lic-State of to i
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identifications Produced Type of Identification Produced*- $STATE
Commission No:P `o��� (9�6#�THER VIZZO Commission No. f 7(0 ER VINO
tNOTARY PUBLICNOTARY PUBLIC
`� ATE OF FLORIDA OF FLORIDA
"Comm#FF176266 W Comm#FF776266
Revised 07/15/2014 m Expires 1111312018 `r��eeIr Expires 11/13/2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS