HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5/5/16 Permit Number: n Is- 0 Sal
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Building Permit Application MAY 17 2016
Planning and Development Services r,
Building and Code Regulation Division Lucie ITunty
2300 Virginia Avenue,Fort Pierce FL 34982 Si. Lucie County, FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial x Residential
PERMIT APPLICATION FOR: Shutter
PROPOSED IMPROVEII�+ I
,ENTL®Ci4TlON t
Address: 9650 S OCEAN DR 1905
Legal Description: THE PRINCESS OF HUTCHINSON ISLAND UNIT 1905
Property Tax ID#: 4502-610-0175-000-3 Lot No.
Site Plan Name: Madeline Roman Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
®ETAI'LED ®ESCR4PT1®N OF UVO� + a -
10 011. �w IS I-Munami
Install 1 Accordion Shutter
CQNSTRl1CT101� INF®RIMaATION ' �; 21
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Additional work to be ertormed under t ispermit—c ec a appy:
E1HVAC Gas Tank ❑Gas Piping Shutters Q Windows/Doors
11 Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 6484.00 Utilities:Sewer Septic Building Height:
"OUIINER/LESS"SEE� �_'
'CO �
Name Madeline Roman Name: Michael Heissenberg
Address:9650 S Ocean Dr Apt 1905 Company: Expert Shutter
City: Jensen Beach State:FL. Address: 1626 SW Biltmore St
Zip Code: 34957 Fax: City: Port St Lucie State:FL
Phone No.862-207-1786 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.
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DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Waiterruitk Name:
Address:6355 NW 36th St Ste 305 Address:
City: Virginia Gardens State: FL 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 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 inte d to obtain financing, consult with lender or an att ey before
commencing wor _ ordLing youXNotice of Commencement.
2" /�7�q4e'4'_�
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_Signature of Ow er essee/Agent U Signature of ontra for/Licen of r
STATE OF FLORIDA � l L
' D r I�� STATE OF FLORIDA Luck COUNTY OF �` 1.�1 COUNTY OF
The forgoing instru enty,� s acknowled ed before me The forgging instrument was acknowledg before me
this -i` lay of 20 _L(IQby this Lr—day of ML20 by
A*)'S Sp n I��
(Name of personacknowledging) (Name of person acknowledging)
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(Signature of NotaryPu lic-State of o cl ) (Signature of Notary 7OR
State of F17 is a
Personally Known OR Produced Identification Personally Known Produced Identification
Type of Identification Produced Type of Identification Produced
((�''rr HEATHER VIZZU I I, HEATHER VI2ZO
CommissionNoTYl oP(1,' 3YPUBLIC Commission No. �7��19`� �ot�yA�o( ARYPUBLIC
o aSTATE OF FLORIDA o ':STATE OF FLORIDA
J &r!4 76966 -smn*FF176966
s��dCE19�� Expires 11/1312J'`' s�l'CE19�e 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