HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: f �3 Permit Number:
RECEIVED IBJ ' 0 3 2016
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 Residential X
PERMIT APPLICATION FOR: Shutter
PRC# OSE�7 tN1PRtVEMETLCCATICJV : .xf
Address: 8003 LAKESIDE WAY
Legal Description: LAKEWOOD PARK-UNIT 3- BILK 21 LOT28
Property Tax lD#: 1301-603-0144-000-9 Lot No.28
Site Plan Name: Geraldine P Short Block No. 21
Project Name:
Setbacks Front Back: Right Side: Left Side:
DET", IL D D� C! t?, zi
Install 14 Accordion Shutters
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Additional work to be nerrormed unaertrus permit-check aappy:
HVAC Gas Tank ❑Gas Piping ffi
_Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 5357.00 Utilities:n Sewer[]Septic Building Height:
OWNER/LE S 1« r r 'R"i CONTRAC
,.. ,.r� ,.w•"F � b .
Name Geraldine P Short Name: Michael Heissenberg
Address:8003 LAKESIDE WAY Company: Expert Shutters
City: Ft Pierce State:FL Address: 668 SW Whitmore
Zip Code: 34951 Fax: City: Port St Lucie State:FL
Phone No.772-489-5977 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION'
DESIGNER/ENGINEER: _Not ApplicableMORTGAGE COMPANY: _Not Applicable MF:
Name: walterrillit Name:
Address:6355 NW 36th sc Address:
City: Virginia Gardens State: FL City: State:
Zip: 3316e Phone: 305-671-1530 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 int nd to obtain financing, consult with le r or an attorn y before
commencing work,, re or4rig yoAr Notice of Commencement.
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_Signature of Own /Lessee/Ag Signature of Cont(ac r/Licens Hol er
STATE OF FLORIDA n STATE OF FLORIDA i
COUNTY OF , �A 1 1 COUNTY OF � r L�LAC?1 "e
The foiling instrument was acknowledged Pefore me The forgoing instrument was acknowledged Idbefore me
this�dayof_N6UPM � 20 LU by this�day of A)OVfA' 101
20 �by
Michael Heissen49 Michael Heissenberg
(Name of person acknowledging) (Name of person acknowledging)
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(Signature of Nota7Pub ic-State of o i ) (Signature of Notary Publ' -State of F16161Personally KnownOR Produced Identification Personally Known 7OR Produced Identification
Type of Identification Produced Type of Identification Produced/
Commission No�-I— i 7�U RYA (SLATHER VIZZO Commission No. 71 7 � �r �Sea4EATHER VIZZO
@oq_ w NOTARY PUBLIC otFRa Ss NOTARY PUBLIC
FLORIDA Qom'` q-rATE OF FLORID
e Comm#FF176266 0 Comm#FF17626
Revised 07/15/2014 °elftEl'V Expires 11/13/2018 s�t�LE1�1`� .EXpires 111131201
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS