HomeMy WebLinkAboutBUILDING PERMIT APPLICATION tACiUOBE�L�EP7ED
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lDat�:
i8,>�ii��di�ln� lP�einmia�:�;piplliilcai�o�n
lPlanning J1,ittf!D,eU/elCo%�lrienct�,N,4fce,5
avildigg and Cade[Regolatkon(DAds4on
2M011/,4vgfnOA oenoe,9:�orztAwrcfL3082
lP,itoMi .X072).4652-15.53 IF=(Q72),462-1578. OOM,rnelrOuall A,esi�lenti,iall
iPiE(RIMirT,AIPiPi1CATIl;OiN Mi>t: TO,Sefeetir�om�d;ropl�o�c,�dt;i�k a;nr�Ow Ot ikhe end sof Rine
IPiR+OIP�OS;ED il!MiPiROVIEIMIEINT IL;OCATiION;:
re-ss::. - - - _S 'V ' --_ e-rCQ - - . - 3-1951--
14egallD gyption: O_- - Q- U - -35 LC l - O ---
-- - -- _ --
P,roperty-TaxcIiD#: D2- 61 11 -6CO-3 [Lot,iuo.
Site;Flan M,a,mi, LB 11 ,1 O
IP,rojest,Na;mp;
Sett asks ,Ero,t IBaslk: Rl ,t S ale:: iL�eft-6,We;.
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.DETA'lIL!EjDDESC;RIIPT,10)) OF 1NtORiK:
P�
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CONS,TRUCT,ION 1NIF,OR!MATIO,N• H
O.,itiona, �wpxj ltp l�,e. .e,;or,me �w;n_.er i s errnit-ci eo a, as pTy.. -
1J,t��VAC GasTan,k �GasPipJ;ng _Slat�tters ❑�UVlndows/Doors
I.1e4ric L44 MM,mlbp;ng O6prink1ers 1:1 Generator Roof luof pito
Total 5ci,Ft of Onarwtion, 5, R.of First Filoor,
host of Constraictiora: --- (��"---- --- -- iltilit es, Sewer Q-5-e
ptic 'Bal ding height:.
;OWN;,ER/LE$$E,E" C,NTRACTO,R;
N.me O blame:
Address; Company,- i A
City, �t2X State, F� r 15
y �- - -- - _ Address,
Zip Code,3�g51 Fc: _ city:V - - -- 5x "�
Phone No, Z Z> -S11 - Zip Code, ?�l n O F= 1-0-5101-3055
F-Bail, Phone No, llc-�-5601 -253?�
Fill In fee simple Title Holder on next page If different E-mail, r4,13gn@--:-nQr���ol
from the Owner listed above) 5tate or County license:CEClLl�SQ�oZ
if�►aiue of construction is$2500 or more,a IRECORDED Notice of commencement Is required,
;5!1JIPALfMIENTAAL�GONSI U,CT{IO,,N LIEN LAW, IIiNPOiR , ''AI ION.
i ID S1CNq� E1V-GZN-EER: v INvt 1ppttca'b;le (NJO;RM # ECOMP N f�- 1NfltAPp;IkAle
1 IN,am,er IImmi e;
i1 d,dress; Atl lres%
city.. State:` Cit4r; State'
{Phone.:. ZP, IPhare
FEE 50APLE"FIT,1EII+IO,LDER, .__._INotAp,p;Iicable IBOND;I.NGCOMPANY: Blot pp;kica'I�,le
IN,a. [Ma.me,:
Address:: ALdd ess:
Cavyr city.
Zip IPhon_e. - :Y,ip:. IP,one:
i
II SerCifijlr tthat irLo magk or itnstdiiat'ton Ihas ommertaedl priono the iissuartce of a ipermii;•
'St.14�gie iQuntyy imak� into ireprEasentation khat is Igrant�i;ng s� remit tiw,i;fl awthori�e the erm:it Iholdar to IbUild the sub�etit§,rtu�.tuir�e
��rh;ic i its i,n comttt t�w.,,iSh any#ppitca:6Le Iikorne Q ,rters Assn canon 1r�,L s,Ibykaws Lor a,RtlpaoYena-,nts itihat may restrtat 9r Ipr�9 i4,it 4i lUh
stat tttture.IPiiaase c9,rtstit��N4Xh�yoU;r IHome�Owrler§gSSogiat lo,n a,RG ireuiew�y9ur cad icor a ny irsi rio>aions�w,hitt"h,rnay a pp;l, •
Iin considor%isen oft Ki e zgra;nting of th;is,rn�ucvst'd Iparmit,i do Ihenel;ly agree that p viii,in ail xespedtts,Iperf,orm the work
iin accordance with t4he approved Ip,tarts,the(Florida IBytiidi•ng Vides aind fit.i4uGie County Amen rrLctnt6.
the tfo,4low-ing(building(permit a,p,plk-aborts a;re epee;,,pt¢from m,4spulgoing a ifiw;li�oortaurrertoy irve,�4r,:,room adtd;itions,
.accessory str4loLur�s,sltulmm1,gg Ipmks,,ferme§,wais,Signs,screen,rooms and a-cv s9,rjy;lJ_sestko arott,er Ron=,r�iden�a,I,tae
W,ARNiIiNG'T�O OWNER-Your�fa.Ilt rre'to;Record ca INOtive of 4om•rrte,ncement;may irgsuit In ►our pa�ling'tw oe;for
mp;roye;me,mts to your proipertyy A INoiKice sof Com.rnence,rnent;must We ire`eorcled a;nd,poste&(An the joboite
(Before th.�,fi,rst iinspeci ion.;If�yos1 iint_encl t- obtain;fi,nanci;ng,,co,nsult with lender or an attor,ney before
ecorn ;e .ci;nR,worilc or;repandi;�, you;r,,Notiice sof Cornme;nce„ent,
s
ivolure of Owner/Il.- ee/, ,n r et- as ernt For�pwner r w,re of Contr�storJLiee;n�e IwolsJ,
STATIE OF F,LOR,10,ASTATE OF FLORIDA
Wi14TY OF Zr C01 0 TTY Of fi�).
The,f,Ing instrument was acknow,ledgedi before;rrte Tlhe;forg9ai7g ;rtSXtu ent was ackfw,ledged be#ore;rwe
2,U abyy this j L day o#_ cTQ of ,20 C2--by
Q
(Na me of Person adktaowaedging)
(,N so of Person acknowledging)
(slgnat.r
of N,aaryPvb lc-Mate df kdrida) (5fgnat!�I #Notary PuliIts State of I Londa
Personally Icown.,,/1�\ _OR Produsoed Identiticatlon---- Personally Known OR Produced pde�7tlfcatlon-----
Type of Identifacatpon Pro used Type of Identlflcatfon Pro. . _.--
,`�OtPRV PVe -, M.
PRY P 4
cofn/�aisslon NO. - �IA M.BRIDGEfl Tommi sslon Ho, - a�_ U°,°= Not a l c MS State of Florida
_._ °..
_ Notary Public-State of Florida ` +�, My Comm.Expires Jul 10,2017
:mom c yr p.
commission g Fr ngg7x;9
Commission,#FF 026752
HwVind 07/1,5/2 4
REVIEWS FRONT ZONING 5UPERVI.509 PIANS VEGETATION 5EA TURTLE MANGROVE
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