HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /
Date: •f 1p Permit Number: ! �
RECEIVED
Building Permit Application
SEP 2 2 201
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
PROPOSEDIMPROVEMENT LCjCATI(7N S
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Address: 10200 S OCEAN DR 403
Legal Description: ATLANTIS III BY THE SEA UNIT 403AND PRO-RATA SHARE IN COMMON ELEMENTS
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Property Tax ID#: 4511-518-0031-000-7 Lot No.
Site Plan Name: Kyle Starkey Block No.
Project Name:
Setbacks Front Back: Right Side:' Left Side:
DETAILED DESCRIPI'{ON OF WORK
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Install 4 Accordion Shutters
CONSTRUCTION""T FO, r n
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Additional wor to be nertormed un er t ispermit—c ec a appy:
HVAC Gas Tank ❑Gas Piping �_Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 2974.00 Utilities: _Sewer Septic Building Height: 60'
OWNER/LESSEE � Y� � ��� �>�� .CONTRACTtR
Name Kyle Starkey Name: Michael Heissenberg
Address: 10200 S OCEAN DR 403 Company: Expert Shutters
City: Jensen Beach State:FL Address: 668 SW Whitmore
Zip Code: 34957 Fax: City: Port St Lucie State:FL
Phone No.567-525-1192 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.
SUPPLEMENT/�l CQNSTRUCTIQ'N LIEN LAW INF�RMATI�N
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 trooms 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_oF+Kprding your U4tice of Commencement.
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_Signature of Owne Lessee/Agent V Signature of Contrac r/License Hold r
STATE OF FLORIDA 3-�,
/ �� I STATE OF FLORIDA � l ��COUNTY OF L COUNTY OF L�
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thiQ��*day of Q 1 tt- 20 L�Vby thisL" J=day of 720U�20 I(o by
Michael Heissenbikg Michael Heissenberg
(Name of person acknowledging() (Name of person acknowledging)
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(Signature of Nota ryYOR
ic-State of d P(Signature of Notary lic-State of )
Personally Known Produced Identification Personally Known iOR Produced Identification
Type of Identification Produced Type of Identification
—1Produced
,
Commission N f 7UQo�o (Seal) CommissionptaRyq($eZhFATHER VIZZO
HEATHER VIZI o�� �� NOTARY PUBLIC
NOTARY PUBLI �$STATE OF FLORIDA
e STATE OF FLORIDA t`
o g s Comm#FF176266
Revised 07/15/2014 � Comm#FF176266CElt1t� Expires 11/13/2018
k-CE A9� Expires 11/13/2018
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