HomeMy WebLinkAboutBuildingPermitApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date..
Permit Number.
Building Permit Application
Plannrn and Development Services
Building and Code Regulation Division
2300 Virg rnia Avenue, .Fort Pierce FL 34952
Phone: K772} 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Commercial
CBDG Funding
Residential X.
PROPOSED I.MPROVEMEN'T.'
:. r
,
Address: 220 VV Arbor Ave
Property I � 1 1- 1 #2 Lod No.
Site Plan Name: Block No,
Project N�me: Fils-Aime
Now Electrical Meter
Second Electrical Meter
(Affidavit required}
FORMA
. }..: •: {.::1++^{-.} { n;;' {;{• is c¢t• � `sr{.u.+o- h
• C t• 5,• Av"
-CONSTRUCTIbNIN'
kk +�
'{ M1•}}}�}khf.hr..hh,.. }•}G{+Dr nY+ }�Yk3•} {, }k }•:h{{4 {r' nt,ti }"'rk•:' ni{�[•{•{}:: r:y.. ••i{, ,�lY i}'{v
..TIO:N
............ .
Additional work to be performed under this permit —check all that apply:
�Mechanical � Gas Tank � Gas Piping X Shutters
Electric � Plumbing _Sprinklers
Total Sq. F t of Construction:
Cost of construction: $ 6,290.00
Generator
Windows/Doors Pored
Roof P itch
q. Ft. of First Floor;
utilities: Sewer Septic Building Height:
Address: 220 W Arbor Ave
City: ��Saint Lurie ._.�._ state: F L
Zip Code: $495
Phone Na. 772-
77-0069
Fax:
. ............... .
Mail:
Fillin fee simple Title Holder on next page cif different
from the Owner fisted above)
E-
M12"+oa}:.
C -N
0. TRACT�*
. f
"`}•t xk' 'r xY2f^' `o-xtt-t• :t: •}'. i
• }v V � �• �o.i
• r S�t•x
— __' �{
,a+�i�.i�7i:r.
���
t'.-. ,. t = : k• �f f } 1�: ,.p,tk: .
J �• ¢, r vot
LULL
Name. Michael
Heissenberg
Coma)a nw
Exr)ert
Shutter
Rp_n irizo.
Address: 668 SW Whitmore Drive
pity: Port Saint Lucie State: FL
Zip Code., 34984 Fax:
Phone No772-8i1-1915
E-Mail permitsaexpertshufters.com
State or County License 16572
If value of construction iS 2500 or more, a RECORDED Notice of Comte is required..
If value of i$7500 r more, a RE RDED blot -I a ofI�rr�r�n���mr� � required,
•-• v v �a __ y�.�_x,v•_�e�nra-a •ua� ?ir.�?••• __ �.,�a,u u vii .. v ,n yvnv La•�S+ • . �:n _}_. . -_..—
SUPPLIEME'NTALCONSTRUN` U C T1 0
...:.. { v`•*• .'� o
• - L)�-'� -
i y .. .
MFORATIONJN
ur• v::a i:aa: .. •�a_� 4v�-:,': x: an... .. .� .. ...... .. .... .. •• .:. • •Y .. M1 f. a j}:} ... �. } b+L .. f
DE
•,ai,.a.�._�...-wM�,�.rr_....._.._,._.�R r,, ;, v.. :.. ryy , . • ..:, r' : - ': <: � } •. f. }. }v Yn, .. ,
SIGNER/ENGINEER.,
ApOcable
MORTGAGE�'1�! ��� �a ,ri e r. Not Applicable
Na rnt
�_p ......
I ,...} Address:
City: Virgil
ZIP
State.
FL
Phone
FEE SIMPLE TITLE HOLD.ER3. Not Appli -
1 able
Addrps',
City.-
z I P Pfl
City. -
State.
zip.* _ Phone,, �
BONDING COMPANY-, Not Applicable
-6
Address.
H.
Y,tMa-•a�a�aM+Y�Fir-�W�_I'+ 1 YIIWY Wa�� a_`NI__..��
G t Y."
Zip P ho ne P
OWNER CONTRACTOR _ T—_-_ ���a�R4'44Wh"4h 4f •v v rrr_ rtw�.. ti.A.rO •--• - •q�•4i�'-L+�2i. �.._tw,�a � ��:�aae:
AFFIDVIT':', l ii I
*s hereby Made to obtain a permit to do the work and installation as Mdicated,
I cerffy th , t n o wo rk or s nstal lat to n h as comet enced p riot to th e issua n ce of a Pe rm'lt.
St. L16 • : t #makes # �/ r # r Lion that i grant' T �i erg , * � I h h
444 * author" the. permit holder u I I thebi rudu `Wh'ch is in coy i with any i•l � Owners Association rules, laws r and . #�tructu ' re, f lease consult with YOur ViOMe Owner!;
Association and review your deed for any restrictions w�lich rnay apply,
{ } * *ra f th o h ereby ag re that I wi I I all respects, perform the work
fn with approved , the t.
The foilow ng building pernilt applications are exempt from undergoing a tull concurrency review:oom. t
accessory ucti rnm i pools, walls, signs, screen rooms and accessory uses to another non-residential use
"WARNINC TO OWNEWYOUR 'FAILURE TO CORD A NOTICE OF COMM CEMENT MAY RIESULT1• -YOUR PAYING
TWIC9 FOR IMPROVEMENTS TO YOUR Roa Yv A NOTICE OF COMMENCEMEMT MUST B RECORDED AND
POSE JOB SITE ST INSpECTION-v IF YOU I END TO
OBTAIN FINAN
WITH 'YOUR LENIDER ORNEY, EFORE RECORDING .-NOTICE Co! ��T/..
{ }
Jr' / {
Y � Apr � J Ar • v� J�
ignatu c, f Owner/ L ntractor Agent Owner Signature
Contractor/Liven Holder
der
STATE
F FLORIDA STATE OF FLORIDA
COUP
COUNTY OFY
r _ fu men t was acknowledged before m
The forgor
' n 'r men+ was acknowledged ��r
this 13
day October 20 l F
this 1 3 day of October 1 by
Michael Heissenberg
i �I.Il ll�r■ — -- - -
Name of
Person afIN
a
,e of I
Prod ur, ed
ersofn making statement.,
Known
Produced identificat-lon
'i i cation 006J� v.w....�_
r
(Signaturo of Notary Public- State 0
Commission No. GG258038
REVIEW1. FRONT
COUN]'ER
DATE w
RECEIVED:
DATE +
COMPLET
w
REVIEW
Michael Heissenberg
Name of person m8�ing statement.
Personally Known yV•,.+,W........_�..�__OR Produced In•tii'
Type of I ni i r)
ProdUced
'����WI��IIY ��a L•L•a•va,.ra�aa�aa�a.�a�ri _._.._..
(Signature of Notary Public- State of Ala
Commission No. GG258038
PLANS
REVIEW
VEGETATION
REVIEW
.0
SEA TURTLE
REVIEW
Shanon UShea,I
NOTARY .IC
ATE OF FLORIO
CmM# GG258048
MANGROVE
REVIEW
.v�.�
�-r:. � W..,.ti �.a ace _ _ r,. ,.�,..�. � �� „�. v •_v: _v. w.
r
3a
�-`+�**'+�{a'a+��l.vwti.�..,�r+� • rr..{.ti � ,f:,r v,..,I. • .- a �. F