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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ��a\ ��� Permit Number:
PECEI','rD JUIN 2 12916
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 X
PERMIT APPLICATION FOR: Shutter
Address: 3020 BENT PINE DR
Legal Description: MONTE CARLO COUNTRY CLUB-UNIT THREE- LOT 268
Property Tax ID#.. 1327-701-0088-000-9 Lot No.268
Site Plan Name: Antonio Doria Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
Install 4 Storm Panel Shutters
Additional work toa er orme under this permit—Check a appy:
HVAC Ei Gas Tank []Gas Piping 12 Shutters Windows/Doors
11 Electric 0 Plumbing Sprinklers ElGenerator Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 3650.00 Utilities: Sewer 11 Septic Building Height:
Name Antonio Doria Name: Michael Heissenberg
Address:3020 BENT PINE DR Company: Expert Shutters
City: Ft Pierce State:FL Address: 668 SW Whitmore
Zip Code: 34951 Fax: City: Port St Lucie State: FL
Phone No.772-460-9950 Zip Code: 34984 Fax:
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: 16572
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: walterTiiiit 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: 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 work or r 'n our NotifiRof Commencement.
S
_Signature of Owner/Lessee/Agent Signature of Contractor/License Holde
STATE OF FLORIDASTATE OF FLORIDA 1
COUNTY OF `:', L\A C I � COUNTY OF f}!'' Luc
The for�o``ing instrument was cknowledg d before me The fling instrument waass acknowledg�d1b-efore me
thi% lay of 20 LSO thi play of �1/I t I!C_, '20
��o by
Michael Heissenberg Michael Heissenberg
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Pu lic-State of Flori ) (Signature of Notary P lic-State of FI )
Personally KnownJ OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
tARYA H ATHER VIZZO 11 I HEA �PEa VIZZO
Commission No '�1�Oo�lllQ`�b ss�Se�� Commission No. 1 _!N�
TARY PUBLIC sow NOT UBLIC
a -STATE OF FLORIDA oe STATE OF FLORIDA
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Revised 07/15/2014 'rVNCEIP Expires 11/13/2018 Ws/PoCEl9�� Expires 1111312018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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