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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: l 1 ro Permit Number: RECEI�.�C NO" 04 016 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 PRCOPOfiED I!MPR©VEMENT LOCATIOaN: Address: 10152 S OCEAN DR 616B Legal Description: ATLANTIS CONDOMINIUM BLDG B UNIT616B AND PRO-RATA SHARE IN COMMON ELEMENTS Property Tax ID#: 4502-803-0053-000-4 Lot No. Site Plan Name: Myra C Riley Block No. Project Name: Setbacks Front Back: Right Side: Left Side: ®ETAILE© ©ERI'PTiON OF WORK Install3Accordion Shutters C«ONSTRUCJig INFORMATION: Additional work to be performed under this permit—check all appy: HVAC Gas Tank ❑Gas Piping �_Shutters Q Windows/Doors Electric 0 Plumbing 1:1U Sprinklers li Generator Roof Total Sq. Ft of Construction: S Ft.of First Floor: Cost of Construction:$ 3781.00 Utilities:Cn Sewer[]Septic Building Height: 70' OWNER/LINSTEE: CONTRACTOR: Name Myra C Riley Name: Michael Heisenberg Address:10152 S OCEAN DR 616B Company: Expert Shutters City: Jensen Beach State:FL Address: 668 SW Whitmore Dr Zip Code: 34957 Fax: City: Port St Lucie State:FL Phone No.317-223-1993 Zip Code: 34984 Fax: 772-871-0990 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 CONSTRUCTION LIEN Vl( INFORMATION: DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: x Not Applicable Name: Tilteco,lnc. Name: Address: 6355 NW 36th St#305 Address: City: Virginia Gardens State: FL City: State: Zip: 33166 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 inspe . f you intend to obtain financing, consult with lender or an attorney before commencing wor r recor i our No "e of Commencement. s _Signature of Owner/Lessee Agent Signature of Contractor/License Holder STATE OF FLORIDA . / 1ie STATE OF FLORIDA c' i v Lt COUNTY OF _34l�l�t, COUNTY OF 7` `C Th �pjing instrument was acknnowledged before me The forgoing instrument was acknowledged before me thisday of 0/�f`11y 20 L by this3� day of Wy4,1^10�20 /�O by Michael Heissen4g Michel Heissenberg (Name of person acknowledging) (Name of person acknowledging) W ' (Signature of Notary Public-State of F d (Signature of Notary Public-State of F ,#) Personally Known x OR Produced Identification Personally Known x OR Produced Identification Type of Identification Produced Type of Identification Produced I n(�,s,n2Y ATHER VIZZO Commission No. / 4�'d�JU (Seal)HEATHER VIZZO Commission No. 1 `° :% "oe� TARY PUBLIC �gnar NOTARY PUBLIC a ' STATE OF FLORIDA 1 "spy r 1�� omm#FF176265 Comm#FF176266 ��t9 Expires 11/13/2018 Revised 07/15/2014 s���cf �� Expires 11/13/2018 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE CO M P LETE INITIALS