HomeMy WebLinkAboutBuilding Permit Application 06/05/2017 10:12 7724663737 BOYLEAC PAGE 01
ALL APPl1 INFO MUST BE COMPLIE:TED FOR APPLICATION To 8E ACCE"W
hate._Wq1_3_ Permit Number: ®�ji ' 007
E"'EIV
Building Permit Application'
Planning and Development Servi es JUN / 5 2017. !
Bulldleg and Code Regu&rtlon Division
2300 Virginia Avenue,Fart Pierre FL 34982
Phone:(772)462-1653 Fax:(772)462-1578 Commercial Resit'
PERMIT APPLICATION FOR: To Select from dmpbox, click em m at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: nwidd f 31$7.r
Legal Description: 116 NWASJOY)
] LOT
Property Tax ID#: _3410-603-0k69 -6004' .. _ Lot No.
Site Plan Name: Block No
Project Name:
Setbacks Front Back:. _ Right Side: .._Left Side:
DETAILED DESCRIPTION OF WORK:
A ` ,,,n r _ NW [..2Y1MC n (v SP.Q.I�� &Gc, c-vwp A C s q e.W�
u K��l-� Cr00 W n 5 Kw
maser Modd f 14ItPX- 0 3O Izo Asir&4[tr KeMA CB(DgLkq
CONSDWCTION INFORMATION:
Ad�ditljohal work orm
oe un er sperm --c ec a appy;
HVAC [3 Gas Tank Cas Piping Shutters ❑Windows/Doors
Electric Plumbing Sprinklers Generator Roof
Total Sq.Ft of Constructio�nl-� Ft.of First Floor.
Cost of Construction:$ �ZS�� �,Q • UtilitiesSewer OSeptic Building Height:
OWNERAESSEF: CONTRACTOR:
Name d1VIlC. Cm KOA Name-
Address: (IIqplutr�j Company:
City: State:0, Address
Zip Code:.3y01$y Fax N City:fmt m in a State: ►
Phone No. ' Zip Code: 3 5, Fax: 1_7e!-4(9(P-*37n
E-Mail: N A Phone No,',M-__fiI- 411+
Nil In fee simple TWe Molder an next page(if different E-Mail. � if DA f,0-tt•nem
from the Owner listed above) State or County License: C&I i$4
If value of constnucuon Is$2-SW er more,a RECORIND Notice of Commencement Is requlmd.
06/05/2017 10:12 7724663737 BOYLEAC PAGE 02 ..
SUPPLEMENTAL CONSTRUCTION LIEN !AW iNEORMATiON:
N6INEER: ,
Not App lrab a MORTGAGE COMPANY.- Not Applicable
Narnt:• Name;
Address: Address:
CRY, state: city.
- Atabe;
Zip; Phone-: ZIP: Phone:
FEE SIMPLE TILE HOLDER: _,- Not Applicable BONDING COMPANY: __Not Applicabie
Name: Name:
Address' Address:
City; Citi
Zip; Phone: zip: Phci
I certify that no work or installation has vmmnarta cI prior to the ha ante of a permit.
St. rrra no rep Mat i3 granting a ptarr>tiit it auth the theCary
R holder to build the subject re
whidr t�In
nflict a tc� a kiome Qwrrs Ilssmiation rules,bylaws orenvrnaMs that may relict orpro
structure. consutt�your Home owners Association and review your d restriction which may apply.
in consideration of the granting ofthls requested permit,t do hereby agree that i will,In all respects,perform the work
In accordance with the approved plans,the Florida Building Codes and St.Lude County Amendments.
fie fallowing building permit aWkstlans are towmpt from underli a full concurrency,review:room additions,
accessory strumous,swimming pools,fences,walls,signs,screen rooms and acmuny uses to another nonlesidential use
WARNING TO OWNER:Yaw Ullum to Retard a Notice of CaMlinO Ment nlsy resuk In year paft twke for
improvements to your property.A Notice of Commencement must be recorded and pasted on the jobsite
before the first Inspectl0n.if you intend to obtain financing,consult with lender or an attorney before
t:ornmencin work or records ur Notice of Commencement
Signature of owner Signature of canttacoorhe Halder
STATE OF FLORIDA CAt,',, STATE OF FLORIDA We,COUNTY OF aT WUIL COUMY OF
TheThe forgoing instrument was admowliediled before me
�ng acknowiedgeOf WJ4 hV me this'L day of jA W, 20 jd by
this(Nance of person adenowied ng i (Name of L4dmedi—ong). .
tit State of Rodda i (signature c r ubM of Florida l
(Signature of Na#ary ,w.
Personally KnownW
dFFNi Personally o o r • --
type of tdetntHicat:ry PubNt•8tgi ai type of id
11 417139 My Comm.Explitt A }�to
Commission No. CtJr m aM1 Auv2 020 Comms mon N111oe1i�Ai1R.
NOtMy�1Mf-
R"Ued 07115/2014
REVIEWS FRONT R ZONING REVIEW SUPERVISOR REVIEW PLANS REVIEW REVIEW �REVIEW E REVIEW
C.otJNTE
PATE
COMPt ETE
INITIALS
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