HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLEINFOMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �1
Date: 11`� i ,' Permit Number: ��a 1 o35a
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� RECEIVED APR 19 2016
�uiiding 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
PERMIT APPLICATION FOR: Shutter
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Address: __ 9 5 5,o
Legal Description: aM 1kcA vv1A4L_ Q-0.J A-%
yea- GGA 60!vI - a oo - y
Property Tax ID n Lot No.
Site Plan Name:_ �0*4 ��a ssa t;4w►E, Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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CQNSTRUCTIN IiVFORiUlAT14N k �� ,
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Additionalworkto be nertormea un er this permit-check all tj3at appy:
HVAC Gas Tank []Gas Piping A_Shutters Windows/Doors
11 Electric Plumbing Sprinklers I Generator E Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ Z"I Z9 z Utilities:Sewer[]Septic Building Height: l 9cL
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Name R55 m frl,... a Name: Michael Heissenberg
Address: q'?6� 5 ca ca...., '7.- x:tk(a3 Company: Expert Shutters
City: —_*\ar.SQ._ State:F Address: 1626 SW Biltmore St
Zip Code: 31157 Fax: City: Port St Lucie State:FL
Phone No. "1-z2_- 7-1.4 - Ob cts- Zip Code: 34984 Fax:
E-Mail: Phone No. 772-871-1915
Fill in fee simple Title Holder on next page(if different E-Mail: CAQ412KAk @_Aak. co"
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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S PP,,�,LEi CAl C 31 ST1 UCTION ti1�i 1 tSIU�s V IVATI } I
DESIGNER/ENGINEER: 0 Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: waiterTiiiit 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 yo intend to obtain financing, consult with lender or an attorne fore
commencing k r cordi9Fg your Notice of Commencement. ,
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—Signature of Owner/Lessee/Agen Signature of Contractor/License Hold
STATE O
®UN OF FLORIDA '54 , J�l� )� COUN®OF ORIDA
The f oing instru en was acknowledge efore me The fn going instrument was acknowledged before me
t...- ay of {► 20 L�y this� _�'day of_ (0 20 L by
'MiOnolkl (Ini'ainet _H�,'5-!�e-n bt(-
(Name of person acknowledging) (Name of person acknowledging)
V
(Signature of Notaryc
Pu lic-State of FI (Signature of Notary Pub' -State of Flo id )
Personally Known N7 OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
(' I'�� I- 11pRy HEATHER VIZZO Na 11 t�- SPaIL
Commission No. T �l� o )NOTARY PUBLIC Commission tpRY ( i HER VIZZO
c ESTATE OF FLORI A �° s�o NOTARY PUBLIC
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Revised 07/15/2014 spa„ Expiros 11/13/2018 '-Comm#FF176266
440E IS% Expires 11/13/2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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