HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED p Q
Date: 1 t O' Permit Number: I l I
Building Permit Application NOV 8 now
Planning and Development Services PERi;jJI-r
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Building and Code Regulation Division S ' Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Shutter
PRaPC+SED IIVIpROVEME,NT„IOCATIO,N ' -°
Address: 6823 Wadsworth TER
Legal Description: OLEANDER PINES BLK 1 LOT 29
Property Tax ID#: 3415-705-0030-000-6 Lot No.29
Site Plan Name: Eileen T Freedman Block No. 1
Project Name:
Setbacks Front Back: Right Side: Left Side:
s
DETAILED DESCRIPTION OF WORK
Install 1 Accordion Shutter & 13 Storm Panel Opgs
CC}NSTRUCT(tQN IN`FQRMATIQN. ,� �. v
Additional workkto be nertormed under this permit—checka apply:
❑HVAC Gas Tank Gas Piping W Shutters Windows/Doors
❑Electric ❑ Plumbing Sprinklers ❑Generator ❑ Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 3145.00 Utilities: Sewer❑Septic Building Height:
C71lI/NEFt/LESS`EE g z 'CONTRACT{?R
Name Eileen T Freedman Name: Michael Heissenberg
Address:6823 Wadsworth TER Company: Expert Shutters
City: Port St Lucie State:FL Address: 668 SW Whitmore
Zip Code: 34952 Fax: City: Port St Lucie State:FL
Phone No.772-873-0027 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.
'two"GONST`RUCTIO LIEN LA11V INFORMATION
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DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: X 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 ins ion. If you int, d to obtain financing, consult with lender or an attor ey before
commencing r r r calrding yoVf Notice of Commencement.
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_Signature of Owner/Lessee/Agent Signature of Contr ctor/License Holder
STATE OF FLORIDA 1 C j't STATE OF FLORIDA f
COUNTY OF (J l COUNTY OF �4, LUC te
The f r oing instrunm�hnt ack owledged before me The for ing instruum'e t s ackpowl edged before me
this I kOt' f RNP l.' (�� �20 �by this IG�day of /V�VkM t 20 I (oby
Michael Heissen4g Michael Heissenberg
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Nota Public-State of Florida (Signature of Notary Pu c-State of Florid
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced�'( � Type of Identification Produced
Commission No � ` (SH THER VIZZO Commission No T�' / ��U/ RY�s-, H WTHER VIZZO
m r 3 >`��WARY PUBLIC o � i ARY PUBLIC
ESTATE OF FLORIDA oati ;STAT E OF FLORIDA
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Revised 07/15/2014 �s�1yb�ExpiresF11/13/2018 �f✓c "g �Expires 11113/2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS