HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: ' �r Y:Z'izlx
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
PROPOSED IMPR'01/Ef1fElUT,LOCATI ;N
Address: 78 Aqua Ra DR
Legal Description: WINDMILL VILLAGE BY THE SEA-UNITTWO- BILK A E 36.72 FT OF LOT 15
Property Tax ID#. 4511-811-0016-000-6 Lot No.15
Site Plan Name: John A Schmid Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
NM
DETAILED'DESCRIPTION �FWORK F
h . ,,.,.
Install 3 Storm Panel Shutters
CONSTRUCTIQNnINFORMATION x§
x
Adcl
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rtiona wor to e e orme under this permit—check a2appy:
HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
11 Electric 0 Plumbing Sprinklers F]Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 995.00 Utilities:n Sewer O Septic Building Height:
C<WNE'R/LESSEE' sh CONTRACTOR
Name John A Schmid Name: Michael Heissenberg
Address:78 Aqua Ra DR Company: Expert Shutters
City: Jensen Beach State:FL. Address: 668 SW Whitmore
Zip Code: 34957 Fax: City: Port St Lucie State: FL
Phone No.772-342-1148 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.
SUPPLEMENTAL CD STRUCTION LIEN LAW NF(JRMATIgN
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: WalterTllllt 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 obtain financing, consult with lender or an attorney before
commencing work or re rdin ur Noticg7of Commencement.
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_Signature of Owner/Lessee/Agent Signature of Contractor/I Holder
STATE OF FLORIDA ��� ,f STATE OF FLORIDA C p
COUNTY OF t COUNTY OF ��j' ,f"C
The forfoing instrument was acknowledged before me ThefoYoing instrument was acknowledg�j Id before me
this :L—§ayof 1 20 Gby thisL dayof YU 20 lb by
Michael Heissen4g Michael Heissenberg
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State oFI ri ) (Signature of Notary Public-State of FI
Personally Known Y OR Produced Identification Personally Known —Y OR Produced Identification
Type of Identification Produced Type of Identification Produced
'1 y HEATHER VIZI c(' y HEATHER VIZZO
Commission Not- NOTARY PUBLIC Commission No.T-Y 1 Lo�U ( I�RY PUBLIC
ESTATE OFF LORI DA «lam' ;STATE OF FLORIDA
s�1'VdE AP
Revised 07/15/2014 Expires 11/13/2018 �NZIR AV4 Expires 11/13/2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS