HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5/5/16 Permit Number:
MAY 17 7016
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 x Residential
PERMIT APPLICATION FOR: Shutter
�PRPOSED IMPROVETaLOCATIO§N �
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Address: 4100 N A1A 411
Legal Description: TREASURE COVE DUNES UNIT 411
Property Tax ID#: 1423-502-0030-000-2 Lot No.
Site Plan Name: Barbara Burkholder(TR) Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
Dffil ED DESCRI'PTION�OF4W@jRKK m � ,
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Install 2 Accordion Shutters
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Additional work to be nertormed under t ispermit—check all appy:
HVAC Gas Tank E:]Gas Piping Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 1646.00 Utilities:n Sewer Septic Building Height:
c a els
01l1lNER10
E�S�SEExb CONTRACTOR _ _ >- �
Name Barbara Burkholder(TR) Name: Michael Heissenberg
Address:6656 Peninsula Dr Company: Expert Shutter
City: Traverse City State:MI Address: 1626 SW Biltmore St 7
Zip Code: 49686 Fax: City: Port St Lucie State.FL
Phone No.231-642-7187 Zip Code: 34984 Fax: 772-871-0990
E-Mail: Phone No. 772-871-1915
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:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SU'PPLEfUIENTAL C0"NSTR"UCJON LIEN LAW INFORMATION: " {,
DESIGN ER/ENGINEER: _Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: WaiterTiiiitir. Name:
Address:6355 NW 36th St Ste 305 Address:
City: Virginia Gardens State: Ft_ City: State:
Zip: 33166 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 thepermit 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 wor_k-&F4ecording yor Notice of Commencement.
ignature of Ow /Lessee/Age \ Signature of Co ractor/License older
COUNTY OFSTATECIFFLORIDA LU /'t COUNTY OF STATE OF FLORIDA I 'r/�
The forgoing instr me t was acknowledged before me Theforgoing instrument was acknowled ed before me
thisfsday of 20 �by this qday of 2q by
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(Name of person acknowledging) (Name of person acknowledging)
SLJ/2W V ,
(Signature of NotaryPu lic-State of Flo ' (Signature of Notary Publi State0194da)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification
' Produced ER V17zrl Type of Identification Produced
Commission No.T T n jq4&a N Y�,isgUC Commission No I7G �' Yq ��SO� F JBLIFLOC
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STATE OF Fi,ORIDA w �' Comm#FF176266
:Comm, , ' ' ' ce t9 � Expires 11/13/20 i 8
Revised 07/15/2014 �14"Va tsx� Expires 11/'i 3/2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS