HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED `] �1
Date: Permit Number: ' I l o�611
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
�? tUPO5E[11l lPONO T LC+(#I' N � :
Address: 6823 Dickinson Ter
Legal Description: OLEANDER PINES BLK 1 LOT 41
Property Tax ID#: 3522-605-0010-000-2 Lot No.41
Site Plan Name: Albert J Pandl Block No. 1
Project Name:
Setbacks Front Back: Right Side: Left Side
C? TAILED DESCRIPTION OF WORK k
Install 3 Accordion Shutters
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GONISTRUCTIQN INFORMATION , }
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Additional worK to e e orme under this permit—check a appy:
❑HVAC �Gas Tank Gas Pi in fVI/_Shutters Windows Doors
❑ p g ❑ /
Electric 0 Plumbing Sprinklers ❑Generator;� ❑ Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 4234.00 Utilities: Sewer El Septic Building Height:
C3WNER/LESSEE 4,; CONTRACTOR' £ ,
_ .
Name Albert J Pandl Name: Michael Heissenberg
Address:6823 Dickinson Ter Company: Expert Shutters
City: Port St Lucie State:FL Address: 668 SW Whitmore
Zip Code: 34952 Fax: City: Port St Luciel State:FL
Phone No.772-466-7783 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.
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St1PPLEMEi�-"AL'CONSTRUCTION LIEN LAW INRQRMATiON '14 A
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DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: walrerTillit Name:
Address:6355 NW 36th Sr Address:
City: Virginia Gardens State: FL City: State:
Zip: 33168 Phone: 305-971-1530 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 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 inspection. If you intend to obtain financing, consult with lender o"r an att ney before
commencing w9rR__d'1\recorftg your,JNotice of Commencement.
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_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA ], ]
COUNTY OF �� , /tC I C COUNTY OF
The for�ping instrument was acknowledge before me The forgoing instrument was acknowledged before me
th� ,day of 20 _by thi� day of Q!�l.t � 20 7 by
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Michael Heissen4g Michael Heissenberg
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Plic-State of t0rVa) (Signature of Notary P lic-State of Flor a
Personally Known OR Produced Identification Personally Known OR Proddced Identification
Type of Identification Produced Type of Identification Produced
/-�63 HEA ��I_J��� otNyy HEATHER URIC
Commission N� l0 @ •��. NOTARY PUBLIC Commission ��'�
>� eiq8TARY PUBLIC
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)n STATE OF FLORI A a r STATE OF FLORIDA
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Revised 07/15/2014 Expires 11/13/2018 Expires 11/13/2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS