HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a� Permit Number: 1—
} M R E CEI'.'-D SEP 2 9 ?.DSS
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
PROPOSED )
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Address: 3920 N Al A 903
Legal Description. OCEAN PEARL CONDOMINIUM (OR 1842-1609) UNIT 903
Property Tax ID#: 1423-505-0031-000-8 Lot No.
Site Plan Name: Leon Fass Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DhECRIPTION OF WORK
k
Install 4 Accordion Shutters
CfJNSTRUCTION INFORMATION
t.
Add
it�HVAC or to e e Gas Tank under this Gas Pit check
❑ a apply":p'eng / I Shutters Windows/Doors
11 Electric ❑ Plumbing Sprinklers I Generator F] Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 1706.00 Utilities:cn Sewer Septic Building Height: 130'
CGINNERjLES5EE° ;CONTRACTOR
Name Leon Fass Name: Michael Heissenberg
Address:3920 N Al 903 Company: Expert Shutters
City: Fort Pierce State:FL Address: 668 SW Whitmore
Zip Code: 34949 Fax: City: Port St Lucie State: FL
Phone No.908-514-1173 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.
r�1'PM YfC �S7�iIl UCr 11✓RfY AI 1
pp MORTGAGE COMPANY: Not Applicable
DESIGNER ENGINEER: Not Applicable X
Name: walterTillit Name:
Address:6355 NW 361h 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 to btain financing, consult with lender attorney before
commencing work or re_ce*ng yQur Not' a of Commencement.
s
_Signature of OwnerrLelrseeAgent v Signature of Contracto Icense Holder
STATE OF FLORIDA i STATE OF FLORIDA
COUNTY OF �4, L C / COUNTY OF ��• L ( I
The forgoing instruments acknowledged before me The forToing instrument was acknowledged before me
thiQI _�ay of d�,)OPr 20 �by thisDb may of 2 4.4 20 ( ( by
Michael Heissenbkg Michael Heissenberg
(Name of person acknowledging) (Name of person acknowledging)
C\/ ')40Jt4A_)
V
(Signature of Notary P blic-State of F ri ) (Signature of Notary Pu c-State of Floi
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
l,, o`�Ry �� HEATHER VIZZO I -( THER VIZZO
Commission `f��� �, NOTARY PUBLIC Commission V� �!pjN'1y44S1
a z, f; p�, NOTARY PUBLIC
STATE OF FLORID � � �
-+STATE OF FLORIDA
'�Or�cE Expires 91/13/201$ ds/f �`Cornrr�#FF976
266
Revised 07/15/2014 aefr9 Expires 11/1312018
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