HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Q'I Permit Number:
RECEI _ ' 1 9616
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: 123 QUEEN ANN CT
Legal Description: QUEENS COVE-UNIT 1- BLK 20 LOT J
Property Tax ID#: 1414-701-0202-000-2 Lot No.J
Site Plan Name: Elizabeth T Hill Block No. 20
Project Name:
Setbacks Front Back: Right Side: Left Side:
Install 19 Accordion Shutters & 1 Roll up
Additional work toe e Orme under this permit—check a2Shutters
appy:
HVAC E]Gas Tank ❑Gas Piping Windows/Doors
DElectric 0 Plumbing Sprinklers 1:1 Generator Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 15,178.00 Utilities:0Sewer 0Septic Building Height:
Name Elizabeth T Hill Name: Michael Heissenberg
Address:123 QUEEN ANN CT Company: Expert Shutters
City: Ft Pierce State:FL Address: 668 SW Whitmore
Zip Code: 34949 Fax: City: Port St Lucie State:FL
Phone No.757-646-4073 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: wailerTillit Name:
Address:6355 NW 36th sr 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 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 ding your No ' e of Commencement.
s
_Signature of Owner/Lessee/Agent Signature of Contractor/Lic se Holde
STATE OF FLORID STATE OF FLORIDA
COUNTY OF L ,v►C 11' COUNTY OF a�. LJ U
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this. %ay of `\ A ice.- 20 �by thiQ 6 W'day of �) k—A 20 ��by
Michael Heissenberg Michael Heissenberg
(Name of person acknowledging) (Name of person acknowledginga�-04.� )Q
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(Signature of Notary70R
ic-State of or° (Signature of Notary70R
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Personally Known Produced Identification Personally Known Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No.� I 1 w� �O (Se��ATHER VIZZO Commission NoE 1(D b (Sea�lI,1
t�yA FEATHER VIZZO
oho ssp�NOTARY PUBLIC �otWY o NOTARY PUBLIC
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
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