HomeMy WebLinkAboutBuilding Permit Application ALL APPLIC BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �f
Date:
�`, Permit Number:sel I's III
i RECEIVED
Building Permit Application AUG -3 2016
Planning a Id Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone. (7 I2)462-1553 Fax: (772)462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Shutter Address: 7440 S OCEAN DR 325
Legal Description: SAND DOLLAR VILLAS CONDOMINIUM A-UNIT 325
Property Tai ID#: 3522-602-0010-000-3 Lot No.
Site Plan Na me: William D Bagshaw Jr Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
Install 1 Accordion Shutter
C 'NSTRUCTION NIA� ''tina or to
nMN
me un er t is permit-c ec a t a apply:
HVAC Gas Tank ❑Gas Piping Shutters Q Windows/Doors
�Electlic Plumbing ❑Sprinklers 1:1 Generator F] Roof
Total '
Ft of Construction: S Ft.of First Floor:
Cost of on $ 1843.00 Utilities:Sewer Septic Building Height: 80'
t ,. u- �-aa- s
EFtLESSEE� r w � ;rd OIVTRACTOR{ M.
:
.. t. ,.
�,. ��
��. .a, m .� ,g �.
Name William D Bagshaw Jr Name: Michael Heisenberg
Address:7440 S OCEAN DR 325 Company: Expert Shutters
City: Jensep Beach State:FL Address: 668 SW Whitmore Dr
Zip Code: 34957 Fax: City: Port St Lucie State:FL
Phone No.060-670-0846 Zip Code: 34984 Fax: 772-871-0990
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.
i
I
I
SIJ P�PLE11/,IENifA C.O;NSTRCT10LIEN` LAUV�INF®RM'ATI®N:: �=
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Ater",Inc. Name:
Address: 6355 NW 36thSt#305 Address:
City; Virginia Gardens State: FL City: State:
Zip: 33166 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
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 ordin ouP/Notice of Commencement.
I
s
_Signature f Owner ess a/Agent Signature of Contra r Li ense Fyclk
STATE OF FLORIDASTATE OF FLORIDA
COUNTY OF �,lC I COUNTY OF
The for oing instrum t was,�acknowledged before me The forgoing instru ent was acknowledged before me
this�day of �/1(i l� 20 Eby this day of HL4q 20 [(;by
Michael Heissen42 Michel Heissenberg
(Name of pe-son acknowledging) (Name of person acknowledgin )
/ ( Y 9 fo�
N3
(Signature of Notary Public-State of Flor'd ) (Signature of Notary Public-StatLof I&Ada)
Personally Known X OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Produced Type of Identification Produced
1 '] ( V'i
HEATHER VIT10 [� 1 ��J HEATHER VIZZO
Commission N� T I UI �,,q? Hyl
, NOTARY PUBLIC Commission
o STATE OF FLORI A ;rrr�^ NOTARY PUBLIC
a
U STATE OF FLORI
em�^ . ` Comm#FF176206
Revised 17/15/ 2014 *42-6E19��° Expires 1111312018 'sr,
Expires 11/93/20
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
I