HomeMy WebLinkAboutResidential Building App1All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: i
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Permit Number:
Building Permit Application
Planning and Development Services
Building and Cade Regulation Division
2300 Virg'nia Avenue, Fort Pierce FL 34982
Phone: (;72) 462-1553 Fax: (772) 452-1578 Commercial
PERMIT TYPE: Shutter
Residential X
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PROO ED V
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P IMPROEM-ENT LOTI
CAN '*�"l
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Address: 235 Nettles Blvd
Property tax 1D : 4 0 - 1- 1-0 0-
Site Plan me: --
Project grn : Rector
Lot N o .
Block No.
SIT.-t: 015
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CONSTRUCTION lNmFORMATIOmN'::m�!�����!�ild:.�.,,.,��n..:.
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Additiona
work to
be performed under tf-iis
permit
— check
all that apply:
Me
hanical
� Gas Tank
� Gas
Piping
X Shutters
Electric
Plumbing
— Sprinklers
Generator
Windows/Doors
Roof Pitch
Total Sq. _t of Construction: Sq. Ft, of First Floor:
Cost of Construct -Ion: 4,697.00 Utilities: Sewer 1 Septic Building Height:
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I Name GY Rector I Name: Michael Heissenberg
Add res s; 235 Nettles I d
City: Jensen Beach State.
i Cod Fax:
Phone No. 1954-347-3313
E-Mail:
Fill in fee simple Title Holder on next page { if different
from the Owner listed above)
If value of
If value of
Company: Expert Shutter Services
Address: 668 SVII Whitmore Dr
City: Port St. Lucie
Zip Code: 34984 Fax:
Phone No 772-871-1915
E- a1i pormits@expertshutters.com
State or County License 1
6572
)n tru tion i 00 or more, a RECORDED Notice of Commencement is required.
VAC is $7,500or mores a RECORDED DED Notice of Commencement is required.
State: FL
UCTION•'LAWINTORMATION.4-..
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DESIGNER/ENGINEER: Not Applic,3.
Not Applicable
Narne* Tikcsu�.
N -ame,� 2
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AddreS54,6,155,NW36m 81
suite �m4 •a i
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Address,
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FEE SIM LE TITLE HOLD.ERV Not Applicable BONDING COMPANY4L -Not Applicable
x Name Nat:
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n ��h-rhti-Jk•ro-na•
City 4
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Address:
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OWNER/pCONTRA OR AFFIDVIT.: A • ii. is hereby made to obtain a permitworkand installation as I i -
i certify thot no work or installation has commenced p't-Jortotheissu.an-ce of a permit, . .
L Lucie Co n'tMakes sio representation that is grantingi WHI authorize the permit holder to buildthe subject structure
which *Is i r with � l i - l � m 'r Association rules# bylaws r and covenants th a t � restrictprohibit such
� � .. �r Lj Home Owners Association and review your deed -for any ricti which may apply.
in consider6flonthe tir) :tt i,equesteo permit, I do hereby agree that I will, in all respects, perform the work
tri accorcian f e�{ � the r plans, the � i Build' Codes and , Lucie my Amend mints.
-1' llowl'Ur building permit li 'ions aye exempt from undergoing a full concurrency r i w{ room Jddmons,
to ry sirii tat , swirnming pouts., fences, walls, signs, screen rooms and accessory uses to an Sr i 4 j use
"v+1ARNIN
its O"NER: YOUR FAILURE TO
I&CORD A NOTICE OF
COMMENCAEME'NT MAY
RESULT IN YOUR PAYING
TWICE
FOR IMPROVEMENTS TO YOURNROPEIITY,
A NOTICE
OF COMMENCEMENT
MUST BERECORDED AND
POST 0 ON THE JOB SITE BEIFORE TH
Wiffm TOUR LENIDIER.OWAS AXTORNEYj
aignature
FIRST • WTWN ., IF YOU ISEND TO 013TAIN FINANCING,
wFORE RECORDING YOUR NOTICE OF —COMM
—----._:.
f Owher/ Lessee/Contractor Agent f4c Owner
STATE OF FLORIDA
COUNTY OF ;j;-, L
i
The. forgo'
tti 13
ay of
ig instrument was acknowiedgied be,(ore me
October , 20 21 by
Michael Heissenberg
Marne r n making statement.
Personally Kriown
_1,ype. of Id ntification
WrodUced
I A Ai
OR Pro6uced Identification
ON-04- - - ------------------ - N , , , mffilffim�
(SignaturO of Notary''Public- Ttate o
C:ammi_Ssign Na. GG258038
RFVIEWS FRONT ZONING
's
COUNTER REVIEW
DATE
RECEIVE
DATA
COMPLE
�_e,V___'&'0,"2_77T
IC
PU-
'�vos 01: f LC
SUPERVISOR
REVIEW
Signature. of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
The forgoing instrument wa:.; acki)owledged before me
t hip _ 13 d October 1 +{r{}
,�. •• « v v nwv - - - nx - - - n.v •{-�..hYhr a•,�m�ar.r. J
Michael Heissenberg
Name of person making staternent.
rflKnows �._�...._.OR Produced Inili-
Prod
+•�=I-P!•I•+T77ii-FYWi�HHdYti}1h+�� i i k I y I i 1 i• i• � rY5 •�i�
{Signature of Notary Public- State of firs
Commission Rio. GG25803.8
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PLANS
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NOTARY PUBLtO
kTATfL_- OF FLORID
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