HomeMy WebLinkAboutApplication ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �n
Date: Permit Number:
Mn
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
00 "3O.
.... .. .......
Address: 9600 S OCEAN DR 601
Legal Description: EMPRESS CONDOMINIUM UNIT 601
Property Tax ID#. ` /S6 a 6 Z O 0-7�37 6VzS Lot No.
Site Plan Name: Ellen J Breslaw Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
pl
Install q Accordion Shutter
3,
it�ona wor to e e orme un er t is permit—c ec a �app y:"
HVAC �Gas Tank Gas Piping �_Shutters �Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 9804.00 Utilities: Sewer F]Septic Building Height: 120'
7 77, �1 gip. � ��� �
Y
Name Ellen J Breslaw Name: Michael Heissenberg
Address:9600 S OCEAN DR 601 Company: Expert Shutters
City: Jensen Beach State:FL Address: 668 SW Whitmore
Zip Code: 34957 Fax: City: Port St Lucie State:FL
Phone No.914-260-8328 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: _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 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 obtain financing, consult with len or an attorney be ore
commencingwor r our NZ e of Commencement.
-K_ 4�e'� -q"_ s
_Signature of Owner/-Lessee/Agent V / Signature of Contra ctor/Licen a Holder
STATE OF FLORIDAU G /I STATE OF COUNTY OF FLORIDA i
COUNTY OF C. �T
The forgoing instrument was acknowledged before me The forgoing
ing instrument was acknowledge before me
thisO'C day of -A l 20 [Lo-by thisWU day of lit 20 ��by
Michael Heissen4rg Michael Heissenberg
(Name of person acknowledging) (Name of person acknowledging)
V r
(Signature of Notary Public-StateFI r' ) (Signature of Notary Public-State of Flo6YadJ
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
I,p W-y HEATHER VIZZO ���I_�i o�pRYgss1-01 HEATHER VIZZO
Commission No. 1 �� aRIOTARY PUBLIC Commission No. 1-?%'.
�o �i6�I�RY PUBLIC
STATE OF FLORID STATE OF FLORIDA
Revised 07/15/2014
/Nc tw Expires 11/13/2018 ce�e�w Expires 11/131201€3
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS