HomeMy WebLinkAboutKelly applicationASI APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Plprrning and Deveiapment Services
Burjdrng and Cade Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax. {772} 462-1578
PERMITTYPE-D Shutter
Permit Number:
Building Permit Application
PROPOSED IMPROVEMENT LOCATION:
Commercial Residential X
Address: 1203 WHITE OAK Ll
Property Tax ID 3409-803-0014-000-0 Lot N a4
Site Plan Names ---
Project Name: Kelly --
DETAILED DESCRIPTION OF WORK:
n t li 1accordion shutters
CONSTRUCTION INFORMATION:
Additional work to be
performed under this
permit
— check
all that apply:
�Mechanical
� has Tank
_Gas
Piping
X Shutters Windows/Doors
Electric
Plumbing
Total Sq. Ft of Construction: _
Cost of Construction: 9,290,00
OWNER/LESSEE:
...........
Name Douglas & Shelley Kelly
Address; PC] Box 785
Sprinklers
Generator
rr
Roof Pitch
Sq. F. of First Floor. ----
ti I iti : � Sewer Septic Building Height:
Cit . L born State: MA
i Coder Fax:
Plione No. 413-329-1689
-Mali:
Fill in
fee
simple
Title Holder on next page if different
from
the
(]weer
listed above}
CONTRACTOR:'
Name: Michael He,issenberg
Company.i Expert Shutter Services
Address. 66.8 SW Whitmore D r
Cit • Port S . Lube State: FL
Zip Code: 34984
Phone No 772-871-191
E -Mail permits@expertshutters.com
State or County License 16572
If
value
of
construction i
$2500 or
more, a RECORDED Notice of Commencement is required*
If
value
of
HVAC is $7,500
or more,
a RECORDED Notice of Co,mmencement is required.
PPI T : TR, CT1 : LIFN LAW INFORMATION,,
. ................ ...... ......... ............. .........
E INEER,. Not Applicable
MORTGAGE COMPANY. Not Applicable
Name -T" #x;
Name:
A d d- r s s ioi 5 NIA; Ath St Sulte 305
A d d r e s�,,;
C 1, t y Wrr 1
S t a t
14 p:{.
Phone
FEE SIMPLE TITLE HOLDER:
M
.....................
NCA Applicabk-.,
City, State,
Zi P 6 P 11 f') e.0
Not Applicable
4 } Name,
................
Address - A- -s+
i t y ...... C i t y
Z ne.: Zip: Phone.--
.......... O NES
CONTRACTOR AFFIDVIT*, Application is hereby ti-iadv. to obttai r n a permit, to do the work and in-sitalla-tion as indicatt-,-H,
y+gy 1For, 4 a! I a t'o ncom m e n c e u t- o t er i s s u n ce of a p r mit k t ii drrh a c t.p
St. W. cl f? r t M a K- n o re p rf� s e nt,-j t o n -flh �i t i s gra n t,, -i ng C') p(--!rrT,ti.t ill the P ernii.t holder to build the Sur)jecl f-i-tRICtUrO
Of ri-j lees. byl -aws or -,). nd COVV -o f I
�i-t may restr4
10, 0 t, P
A j). ntS h'b't s u
W h ich is i n c 01-1. fict wit' h a 11)? ap Ca b! ..
iIL n 2 u tion
torarw rt�!Arictiow--,=) which rri:-v apply�
o Clat 10; &ed
structkur(-) - Please C01-1sult W,th your. lonlc� owne A�,-s n --ind review yr.)�,jr i
0
In
lit i d -O -eby aguee I -[id , cons'lder�-clon of thegrantingof ',,.his reqtx.�stecj (2 rn I ,
t I w'l 1, 'n ill respects, perf'o-, the work
Pn accordarn-Ce witffi u -1c approved Plan,%, the Floridi-,--, Buldlofirig Codes and 5L. Luc. e 1.1y-ty Afrl:'ndm nt
The following buildin�7, pern-iit applicationis iire- exempt fi-04-11 Llndergoiiv rc;view. room addi",Jorl"54
a full c
L
accessoirk.,, f -structures, L.Wi fritll Ill g poo�s;, Tt�ncv-s, walk, silit.uit-.. f'(Wm,s a!-itl accessory usesto use
i"ARNINC'1-0 OWNER.. YOUR FAILURE TO
TWICE FOR IMPROVEMENTS TO YOUR
POSTED ON THE JOB SITE BEFORE TH
R a NrW RE. !ww
WITH YOUR LENDER 4110 "
j�,
.7
Ygnature of Gwrit--sr/ Le-ssee/'Cun tr actor, a,,,; ent*fc- Ownt-'..r
STATE OF FLORIDA
COUNTY OF ZYt L
. I � -1 1 , 4
The forgo r),70 tr u t-ne nt was a Ck nowlec 1 f.- ci before fne
b
r�ictiaeiHel's
Name of person. maldn atem
ent.
Per-�onal ly Known —4 OR Produced Identific'.1,11,1c'm
lype.of earn tificatfori
Produced
-
---------------------
(Signature ot �
Commislur
i N(
i
Av W
kT. ARY 1>U3L1G
OF F6
�ol Jos
. .. . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . .
de 3
....... . .............. . .. ........ ........
W(
®rt -t 0 Of C (ir lb Holder
STATE OF FLORIDA
COUNTY OF°�y { "r
Th } torgoing instrument wa.s acknowledged before me
..)y d of 204, by
IVT
...................... 11-
Name of. person making st("atement.
Personally Known OR Pf oduced lde'ntificri,tion
'rytie of Identifi-catiot)
ff
P
(Si8nature ot Notary fLiblic.- State of Flor",
hanon 0
NOTARY pUBLIq
b .� TATE OF FLORtw
;Onlm# i3G
tA
Kt-Vitfib f-KUN I -4UNIN6 SrL)PERV'150R PI -ANS
COUN'TER R EV I [W V I
r RE -VIEW
---------------- .........
DA 1
RECEIVED
DATE
COMPUTE. D.
. ..............
277ffg"• -- .......... .......
V E 6 E TA T1 ON
R E V I E, -'VY
SEA'FURTLE
fit. -VIEW
M AN Gj 110 V E
REVIEW