HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED iI
Date: 1 �`� Permit Number:
R CE14' D APR 15.2016
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 Residential ar
PERMIT APPLICATION FOR: Shutter
g,..�,. xU01'4
r"
""NMM V .: e\r
✓ - .,,z- +.
x
Address: -1 0 5 pc-crr 'b,- -- '-(2b�
Legal Description: 15�n.7 �� 1 k A ,. V/tk" C.'ae.0
Property Tax ID#: 3S 2 2 - (oma Z- O.z%y 00ko- I Lot No.
Site Plan Name: _'Sz5L _1�s Ag,A VA Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
RAI
STA<< 1 PtCc.o��CON 5�•-�G✓
tai='§.�,s,as �,,&v ,��s�"x:.,«, 'tea {.�"„�E z' a `�Z"�a w's` '. � a'-p 7 .� ,� x,yrs+ �� t -, ✓:�.�� a :r
itiona wor to e e orme un er t is permit-c ec a app y:
HVAC �Gas Tank ❑Gas Piping �_Shutters �Windows/Doors
Electric 0 Plumbing Sprinklers �Generator �Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
i
Cost of Construction:$ Z42_1 Utilities: _Sewer[]Septic Building Height:
WNER/LESSEE CONTRACTOR
"ai�, xro._..s'l, ._2_. t,vt.t<�'`�r"�„ � vr4 z sxs .kt ..< na't.. .a �.w,,:..£.> ..a ..�:,..�wxx_�d2.,_.-,..'Kr3 w+.
4 r% _ '�.. Y{s;r{ t R:'�z»� .� tX s.
Name Name: Michael Heissenberg
Address: Ldp Sw ,5'� GE Company: Expert Shutters
City: _L>A-"'Ah State:_EL Address: 1626 SW Biltmore St
Zip Code: 333)'1 Fax: City: Port St Lucie State:FL
Phone No. Q.!S-i-1 (.0 1,_t9 - (.09Lq 3 Zip Code: 34984 Fax:-
E-Mail: Phone No. 772-871-1915
Fill in fee simple Title Holder on next page(if different E-Mail: -ob-,
from the Owner listed above) State or County License:r16572
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
s
DESIGNER/ENGINEER: 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 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 int d to obtain financing, consult with len or an attorne before
commencingwor r cordin o Notice of Commencement.
s
_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE.COUNTY F ORIDA Lu r li� COUNTY OF OSTATE OF ItIDA 5+` f � I�
The fcging instr m nty.✓as acknowledge efore me The orp�oing instru e t was acknowledged before me
this 5� hiayof C / 20 �by thi,=day of ! ) 20 by
-pn 1 C � �� )
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary7OR
-State of Florid ) (Signature of Notary Pu ic-State of FloriPersonal/ Known Produced Identification Personal/ Known 7 OR Produced Identification
YV
Type of Identification Produced Type of Identificcaa'tiion-Plroduced
" 7b Ott Y A � oe Yq4oH�T RVIZZO
Commissiono (Se4ATHER VIZZO Commission NoTNPUBLIC
o NOTARY PUBLIC aSTATE OF FLORIDA
« t6Rt o 0
w lNtt
Revised 07/15/2014 �'r� w' Comm#FF176266 s��cEA Expires 11/13/2018
�cE 10 Expires 11/13/2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS