HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED `� a
Date: '\ %. Co Permit Number: %d
RECEIVED APR 18 2015
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 3Residential 0
PERMIT APPLICATION FOR: Shutter
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Address: 'J —7 ►J 1 p,
Legal Description: Oekaw 1 FyC�h� cam
Property Tax ID#: kLtl1 - -109 005'3 - 000 -Z Lot No.
Site Plan Name:_ W`.�\:o.w� +M;�\�dL Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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Additional work to be ne rmed under this permit-cfieck all that appy:
HVAC Gas Tank []Gas Piping 14 Shutters Windows/Doors
11 Electric 0 Plumbing Sprinklers F Generator a Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ ka met Utilities:o Sewer❑Septic Building Height: 1?�
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Name: Michael Heissenberg
Address: 1,151(e7 N Ate 9tL8c>%A Company: Expert Shutters
City: 1--y State: Address: 1626 SW Biltmore St
Zip Code: 3L{9 49 Fax: City: Port St Lucie State:FL
Phone No. 717-- SQ'' '5ZIG8 Zip Code: 34984 Fax:
E-Mail: Phone No. 772-871-1915
Fill in fee simple Title Holder on next page{if different E-Mail: CA11tW2KA*e_Aak. cow.
from the Owner listed above) State or County Licenser 16572
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Waiterriiit 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.
t 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 ipend to obtain financing, consult with lender or an attorney before
commencin w 'Cex,prcling VAKIr Notice of Commencement.
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_Signature of Owner/Lessee/Agent Signature of Con r ctor/License Ho de
STATE OF FLORIDA I ��/ I�_Q STATECOUNTY OF FLORIDA I u ()
COUNTY OF ..J-t` l.. l�
The f rgoing instry,}A�ient was acknowledged before me The fo oing instr ent was acknowledgedbeforeme
this Itday of H Q(1' ) 20 L(vby thisl 'day 20 b by
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(Name of person acknowledging) (Name of person acknowledging)
V � V
(Signature of Notary
`Pu*c-State of FI r' (Signature of Notary Publi -State of )
Personally Known70R OR Produced Identification Personally Known 70R Produced Identification
Type of Identification Produced Type of Identification Produced!
Commission No 1r 11 �U)Wo rlWy al)HEATHER VIZZO Commission N1 /710a6�0 &4�*SC��ATHER VIZZO
o� oNOTARY PUBLIC eo N TARY PUBLIC
STATE F FLO_RI A °C STATE OF FLORIDA
u Comm#FF176266 " r Comm#FF176266
Revised 07/15/2014 Expires 11/13/2018 4/a tel% Expires 11/13/2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS