HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4/22/16 Permit Number: 6 —0
Building Permit Application
Planning and Development Services
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Building and Code Regulation Division PERtfI-rTltqG
2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucie County, FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial x Residential
PERMIT APPLICATION FOR: Shutter
FROP®SfDIMI?ROVEMENT'LOCATION: Fx _
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Address: 9950 S OCEAN DR 801
Legal Description: MIRAMAR ROYALE UNIT 801
Property Tax ID#: 4502-703-0032-000-4 Lot No.
Site Plan Name: Richard A Delaney Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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TAIL§ED DESCRIPTION OFzVUORK: mirl
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Install 2 Accordion Shutters
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Additionalwork to be nertormed under t ispermit—check all appy:
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:$ 6856.00 Utilities: Sewer 0Septic Building Height: 170'
Name Richard A Delaney Name: Michael Heissenberg
Address:9950 S OCEAN DR 801 Company: Expert Shutters
City: Jensen Beach State:FL Address: 1626 SW Biltmore St
Zip Code: 34957 Fax: City: Port St Lucie State.FL
Phone No.772-229-7730 Zip Code: 34984 Fax: 772-871-0990
E-Mail: Phone No. 772-281-1915
Fill in fee simple Title Holder on next page(if different E-Mail: callexpert@aol.com
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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SU`PrPLEIUIENTAL CONSTRUCTION°LIEN.LAW INFORMATION ` . ; M
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Walter Tillit Jr. 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 intend to obtain financing, consult with lender or an attorney before
commencing work or recordin ur Notic of Commencement.
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_Signature of Owner/Lessee/Agent Signature of Contra or/L' ense Holder
STATE OF FLORIDA � 1_ 1 t ,I C 1� D STATE OF COUNTY OF
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COUNTY OF T L�VI L
The forgoing instr ent was acknowledged before me The forgoing instrument was acknowledged before me
thi��''clay of AIC I 20 L thi�Aday of AI✓l> > 20 �� by
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(Name of person acknowledging V (Name of person acknowledging)
(Signature of Notar7_011
State of FI ria I(Signature of Notary Publi -State of r'
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Personally Known Produced Identification Personally Known 7OR Produced Identification
Type of Identification Produced HEATHER V177c) Type of Identification Produced nt HEATHER VIZZO
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NOTARY PUBLIC
��1- (-) NOTARY PUBLICF-I-IaCommission No. � S�STATE OF FLORIDA Commission N �'�E OF FLORIDA
^'z Comm#FF176266 Comm#FF176266
lr 9� Expires Expires 11/13/2018
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS