HomeMy WebLinkAboutApplication ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED rr__te�rr GG
Date: Permit Number:
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
Address: 9500 S OCEAN DR 401
Legal Description.. ISLANDIA II CONDOMINIUM UNIT 401
Property Tax ID#: 4502-602-0025-000-2 Lot No.
Site Plan Name: Gary M Donaghy Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
Off
{ ' x
Install 1 Accordion Shutter
Ag
-A-ddi—tional work toe e orme under this permit-c ec a appy:
0HVAC E]Gas Tank F_]Gas Piping Shutters ❑Windows/Doors
11 Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction: $ 7210.00 Utilities:Sewer 0 Septic Building Height: 200'
Name Gary M Donaghy Name: Michael Heissenberg
Address:9500 S OCEAN DR 401 Company: Expert Shutters
City: Jensen Beach State:FL Address: 668 SW Whitmore
Zip Code:
34957 Fax: City: Port St Lucie State:FL
Phone No.772-446-4242 Zip Code: 34984 Fax:
E-Mail: Phone No. 772-871-1915
Fill in fee simple Title Holder on next page(if different E-Mail: calfexpert@aol.com
from the Owner listed above) State or County License: 16572
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
1
DESIGNER/ENGINEER: Not Applicable x p �
pp MORTGAGE COMPANY: Not Applicable
Name: walterTillit
Name:
Address:6355 NW 36th St Address:
City: Virginia Gardens State: FL City: State:
Zip: 33168 Phone: 345-871-1534 Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney befo e
commencing work o rcling your NotiQ6 of Commencement.
s
_Signature of Owneff essee/ gent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA 1
COUNTY OF '�4u I't COUNTY OF f�. L
Th forgoing orgoing instrument was acknowledged before me Th$forgoing instrument was acknowledged efore me
thi ''day of 7T l,_1 L J _ 20 t+ by thistQ��-�day of _!5—i.-4 I 20 by
Michael Heissenb6rg Michael Heissenberg
(Name of person acknowledging) (Name of person acknowledging)
�� v
c (:Vit'
(Signature of Notary Public-State of Flo y1w (Signature of Notary Public-State of Flo ld
Personally Known OR Produced Identification Personally Known L�<' OR Produced Identification
Type of Identification Produced Type of Identification Produced
HEATHER VIZZO ( F� AVER VIZZO
Commission N tl�lnt�QyotaerOTARY PUBLIC Commission N t }I �r n Ij Y PUBLIC
-STATE OF FLORIDAI a STATE OF FLORIDA
om
Revised 07/15/2014 "NNE 19P Expires 11/13/2418 ��" t��e Expires 11/13/2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE -2-7-1(o
COMPLETE
INITIALS -J 4111 1