HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:q j awl !� Permit Number:
RECEI ti'rD JUN 2 2 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 Residential X
PERMIT APPLICATION FOR: Shutter
Address: 5861 TRAVELERS WAY
Legal Description.. PALM GROVE S/D BLK C LOT 7
Property Tax ID#: 3410-503-0075-000-8 Lot No.
Site Plan Name: Michael P Morgese Block No. C
Project Name:
Setbacks Front Back: Right Side: Left Side:
Install 1 Accordion Shutter
Additional work toe e orme under this permit—check a appy:
HVAC 11 Gas Tank []Gas Piping Shutters ❑Windows/Doors
❑Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction: $ 3078.00 Utilities:n Sewer F]Septic Building Height:
Name Michael P Morgese Name: Michael Heissenberg
Address:5861 TRAVELERS WAY Company: Expert Shutters
City: Ft Pierce State:FL Address: 668 SW Whitmore
Zip Code: 34982 Fax: City: Port St Lucie State:FL
Phone No.772-465-9162 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: WalterTillit 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 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 toobtain financing, consult with lender or an attorney before
commencing work or re in yqur Noti f Commencement.
s
_Signature of Owner/Lessee/Agent y Signature of Co tra for/LI nse ft'oldj6r `
STATE OF FLORIDA �� FLORIDA 1' )L� J�
COUNTY OF 1. COUNTY OF T
The forgoing instrum nt was acknowledged before me The forge ng instrument was acknowledged efore me
th _day of 20 Eby this gay of Z!� A(\t 20 �by
Michael Heissenberg Michael Heissenberg
(Name of person acknowledging) (Name of person acknowledging)
2L��� WJ�9�
(Signature of Notary 70R
c-State of For' (Signature of Notary 70R
c-State of Flo id
Personally Known Produced Identification Personally Known Produced Identification
Type of identification Produced Type of Identification Produced
Commission NT-f ) (,�10 tPRvgSr SPH� HER VIZZO Commission NO-4 /� *tw
�(THER VIZZO
e �fOTARY PUBLIC � TA+RY PUBLIC
15TATE OF FLORIDA
� ESTATE OF FLORIDA °,
�+ Comm#FF176265 6n1rfl •176266
Revised 07/15/2014 � CE}9_1% Expires 11/13/2018 r6 EXPIres 11/13/2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS