HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: \�a`1`» Permit Number:
- -; RCCEI'.'-D SCP ? 9 2076
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 11111 , 0W,MENT LOCATll3N,
Address: 3100 N AIA PHB04
Legal Description: SANDS ON THE OCEAN-SECTION 1- UNIT PH134
Property Tax ID#: 1425-606-0074-000-7 Lot No.
Site Plan Name: Dreta Roggenbuck Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DE`SCRIPTION`QFWiORK ` J
Install 1 Accordion Shutter
CNSTRUCTIONJ,
fV'FORIVIATION °
:. -
Additional work to e—e orme under this permit–ch ec a apply:
❑HVAC be
[]Gas Piping Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 3696.00 Utilities:n Sewer[]Septic Building Height: 130'
01NNER/LESSEE
n CONTRACTOR
Name Dreta Roggenbuck Name: Michael Heissenberg
Address:3100 N Al PHB04 Company: Expert Shutters
city: Fort Pierce State:FL Address: 668 SW Whitmore
Zip Code: 34949 Fax: City: Port St Lucie State:FL
Phone No.248-238-3756 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.
SUPPLEMN7AL CaNSTRUCTIQN I.IN LAW 1NFORMTIC?N
>,
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _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 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 int4nd to obtain financing, consult with lender or an attor, y before
commencing workjor_xecording y9or Notice of Commencement.
s
_Signature of Owner/Lessee/Agent U Signa ure of Contractor/License Ho de
STATE OF FLORIDASTATE OF FLORIDA /
COUNTY OF ��- U C)-Q COUNTY OF L IJt
The forgoing lnstr ent Was acknowledge before me The forgoing instr en was cknowledgfed/before me
thi �qday of Q 7"-Q M F 20 ��by this day of p�N1�t'/ ,201 l�by
Michael Heisse4g Michael Heissenberg
(Name of person acknowledging) (Name of person acknowledging)
cv 962�� 01/"4)
(Signature of Nota70R
lic-State of I &16) (Signature of Notary Pu c-State f I r da)
Personally Known Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
(' HEATHER VIZZO l I_ gpgy HEATHER VIZZO
Commission �y NOTARY PUBLIC Commission N to YJ �o �I)
NOTARY PUBLIC
-�
—STATE OF FLORID
o STATE OF FLORID
J�N''E 10"'w Expires 11/13/2018 I`Ys�ycE i�i0` Comm#FF176266
Revised 07/15/2014 Expires 11/13/201
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS