HomeMy WebLinkAboutBuilding Permit Application ALL APPLICA LE INFO MUST BE COMPLETED FOR APPLICA ION TO BE ACCEPTED
Date: Permit Number: 09.0
YZ
RECEIVE®
Building Per it Application
SEP 2 9 201
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Com ercial Residential X
PERMIT APPLICATION FOR: Shutter
�PFtC PO ED t PR 7UEMEsNT I`QCAT' ICN t k,
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Address: 10137 Spyglass Ln
Legal Description: POD 26 AT THE RESERVE PHASE 1 CYPRESS POINT LOT 12
Property Tax ID#: 3327-707-0016-000-8 Lot No.12
Site Plan Name: Alan L Norsworthy Block No.
Project Name:
Setbacks Front Back: Right Side Left Side:
DETAILED 9ESCRIPTI0N WORK s
a'II
Install 5 Storm panel Shutters
CONSTRUCT{ N INFORM�1T10N
itionalwor to e e forme underthispermit—c a a sappy:
11HVAC E]Gas Tank ❑Gas Piping �_Shutters ❑Windows/Doors
11 Electric ElPlumbingSprinklers ❑Generator ❑ Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 1039.00 Utili ies:cn Sewer E]Septic Building Height:
aWNER/LSSFE� ,3 p ° ' , CONTRACTOR
,o*,�a..�,;. <yi .:tom,.?....t.z ,S[at�•.asr2=.�x .^r.' n?'
Name Alan L Norsworthy Name: Michael Heissenberg
Address:10137 Spyglass Ln Company: Expert Shutters
City: Port St Lucie State:FL Address: 668 SW Whitmore
Zip Code: 34986 Fax: City: Port St Lucie State:FL
Phone No.772-834-3444 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 f Commencement is required.
5UPPLE;MENTAL CON5TRICT(.ON LIEN LAW'INF RMATIONYa
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DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: walterTillit Name:
Address:6355 NW 36th St Address:
City: Virginia Gardens State: FL City: State:
Zip: 33166 Phone: 305.671-1530 Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the ssuance of a permit.
St. Lucie County makes no representation that is granting a permi t 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 her/ by agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Code and St. Lucie County Amendments.
The following building permit applications are exempt from unde going 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 fina ting, consult with lender bef an attorney re
commencingwork or re in ur Noti of Comm ncement.
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_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA e ) _` �� FLORIDA 1
COUNTY OF )- COUNTY Ll
ZTh rcZing instr a as acknowledged before me The or oing instrument as acknowledged before me
day of 20� by thiday of Q QJ( 20 by
Michael Heissen4g Michael Heissenberg
(Name of person acknowledging) (Name of person acknowledgin
Dzv"'
qfQiA— -
V
(Signature of Notary P lic-State of FI ri I J) Pubof Notary Public-State of Flo d )
Personally Known OR Produced Identification Personally Known V OR Produced Identification
Type of Identification Produced Type of Identification Produced
HEATHER VIZZO
g
a� b ,+H�AT R VIZZO
al}TARYCommission 40-7-R-- PUBLIC CommissionNPUBLIC
OF FLORIDSTATE STATE OF FLORIDA a )c
Cox rin d*IFF i 76266
'01'r�tii;f i9�`° Expires 11/13/201 'JkZmE �% Expires 11/13/2018
Revised 07/15/2014 p
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS