HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /
Date G__
Permit Number: _
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Building Permit Application
P'ca�4c`�r ;rks
Planning and Development Services 5L: L 'es qnf� F
Building and Code Regulation Division �0.
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Shutter
PRO POSED:IIUIPRQI/EME-NT LOCATION
Address: 3200 N Al Apt 1110
Legal Description. SEA PALMS UNIT 1110 AND PRO-RATA SHARE IN COMMON ELEMENTS
Property Tax ID#: 1425-600-0106-000-3 Lot No.
Site Plan Name: John T Grange Block No.
Project Name: '
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
Install 2 Accordion Shutters
CONSTRUCTtQN INFORMATION '
Additional wor toe nertormed under tispermit—check all appy:
❑HVAC Gas Tank Gas Piping V Shutters ❑Windows/Doors
11 Electric ❑Plumbing Sprinklers 1:1 Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 1142.00 Utilities: _Sewer Septic Building Height: 100
OWNER/LESSEE CONTRACTOR
Name John T Grange Name: Michael Heissenberg
Address:3200 N Al Apt 1110 Company: Expert Shutters
City: Ft Pierce State:FL Address: 668 SW Whitmore
Zip Code: 34949 Fax: City: Port St Lucie State:FL
Phone No.772-713-8110 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.
S.,YPPLEMENTAL CONSTR,IJ7T 10I LIEN LAW iNFOftMATION
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 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 inspeotio ou intend to tain financing, consult with lender or an attorney before
commencing work or ecordi our Noti of Commencement.
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Sigtfature of Owner/Le see/Agent Signature of Contractor (cense Holder
STATE OF FLORIDASTATE OF FLORIDA ]
COUNTY OF � Luc C i COUNTY OF L� C
The forVing instr gnt was acknowledged before me The forgoing instrument was acknowledged before me
this 15 play of CL Y bZ f 20 �by this l 5 t day of M b e/ 20 I In by
Michael Heissen4g Michael Heissenberg
(Name of person acknowledging) (Name of person acknowledging_q"' )
�/ ` && 9LWI�Tp
(Signature of Notary Pu lc-State of For ) (Signature of Notary Pu lic-State of 64i6AV )
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
�T, ?��� ;p�Ri2Y��s � � VIZZO ['('� HEATHER VIZZO
° VOTARY PUBLIC Commission Noj(: — l 7 � s
Commission No. .,;. Y \��Nt( #}(PUBLIC
0
TATE OF FLORID «lG"=: ' +STATE OF FLORIDA
Comm€;:FF 176 F^ c� � ..t��a 2
'✓cs te' Expires 11/13/2018 `�' ��% Expires 11/13/2018
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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