HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:jgyj
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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
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Address: 7420 S OCEAN DR 516
Legal Description: SAND DOLLAR VILLAS CONDOMINIUM C-UNIT 516 AND UND PRO-RATA SHAREIN COMMON ELEMENTS
Property Tax ID#: 3522-604-0029-000-5 Lot No.
Site Plan Name: Henry Supan Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
4.
Install 4 Accordion Shutters
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o'na wor to e e orme under t is permit—c ec a apply:
0HVAC 11 Gas Tank []Gas Piping Shutters F]Windows/Doors
0 Electric 0 Plumbing Sprinklers E]Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 1966.00 Utilities:n Sewer Septic Building Height: 80'
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Name Henry Supan Name: Michael Heissenberg
Address:7420 S OCEAN DR 516 Company: Expert Shutters
City: Jensen Beach State:FL Address: 668 SW Whitmore
Zip Code: 34957 Fax: City: Port St Lucie State:FL
Phone No.845-709-4542 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 to ohtain financing, consult with lender or an attorney before
commencing work or recer4ing your NoticizARommencement.
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_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA r,tp� STATE OF FLORIDA
COUNTY OF L�41�.. COUNTY OF c.�- � C 1
The forTing instrument was acknowledged before me The for oing instrument was acknowledg before me
thisi day of U1 I 20 �by this[!?=��'day of �—'20 �by
Michael HeissenbOrg Michael Heissenberg
(Name of person acknowledging} (Na a of person acknowledging}
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(Signature of Notary//Public-State of Fi i (Signature of Notary Public-State of Flori }
Personally Known✓'< OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission . �Wal) HEATHER VIZZh Commission Ng 1�01 � y� eal)HEATHER VIZZO
or NOTARY PUBLI —NOTARY PUBLIC
Revised 07!1512414 Comm#FF176266 Comm#FF176?So
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Expires 11!13/2018 Et9�0 Expires 1111,312L i
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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