HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE IQdFO M ST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: JICIO Permit Number:
J '
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
PROPOSED IMPROVEMENT LO,
CATIQN <
Address: 4708 Seagrape Dr
Legal Description: INDIAN RIVER ESTATES-UNIT 07- BLK 39 LOT 9
Property Tax ID M-34-1 0-583-04-78-8808 93� t No.9
Site Plan Name: Jayne Mattiello Block No. 39
Project Name:
Setbacks Front Back: Right Side: Left Side:
6ETAILEU:0ESC RIPTION.,QF WORK.
Install 7 Storm Panel Openings Shutters
CbNSTRUCTION�INFORNI'ATION
al work to be nertormed under this permit—check a appy:
11 HVAC Gas Tank Gas Piping � Shutters ❑Windows/Doors
Electric ❑Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 1432.00 Utilities:In Sewer Septic Building Height:
ODUNEf2/LESSEE n ' CONTRACTOR
E R
Name Jayne Mattiello Name: Michael Heissenberg
Address:4708 Seagrape Dr Company: Expert Shutters
City: Ft Pierce State:FL. Address: 668 SW Whitmore
Zip Code: 34982 Fax: City: Port St Lucie State:FL
Phone No.772-370-0429 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.
SLIPPLE(VINI'AL CO'NSTRUCTIQN LIEN LAW INFQRIVIATIt�N A.
DESIGNER/ENGINEER: x Not Applicable x MORTGAGE COMPANY: XX 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: x 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 d to obtain financing, consult with lender or an attorney before
commencingwo ore r 'n otice of Commencement.
29A4� I s
_Signature of Ow r/Lessee/Agent Signature of Contractor/License older
STATE
OY F 54, L�C 1 FLORIDA +_e STATE OF FLORIDA Sk / biC;k
COUNTY OF
The foRing instrLament was acknowledged before me The forgoing instrument was acknowledged before me
thisi5 -,day of aMID-Cr 20 �G by this day of Q Cel b-t f 20 �� by
Michael Heissenbkg Michael Heissenberg
(Name of person acknowledging
(Name of person acknowledging)
C\/��
(Signature of Notary P lic-State of Flor da (Signature of Notary Pykslic-State of Florid )
Personally Known OR Produced Identification Personally Known � OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No
i' 17(�ab4� ogpP I) HEATHER VIZZO Commission Nr (,a�� aq l) HEATHER VIZZO
gy
\pC,
NOTARY PUBLIC NOTARY PUBLIC
m�/`v' a �2 STATE OF FLOR! A a ti STATE OF FLORID
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Revised 07/15/2014 5�4'Z Oq Expires 11/13/2018 s�1JWWARP Expires 11/13/20
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS