HomeMy WebLinkAboutBuilding Permit Application 05/31/2017 10:27 7724GG3737 BOYLEAC PAGE 01
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �1 d 5 CSG 5
Permit Number.
RECEIVED MAY 31. 1017
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2900 VJrginia Avenue,Fan Fleece Ft 3082 /
Phone:(772)462-1553 Fax:(772)452-1578 Commercial _T_ Residential V/
PERMIT APPLICATION FOR: To Select from dropbox,click ar mw at the end of line
PROPOSED IMPROVEMEN%T LOCATION:
Address: �l j 6 J�
Legal Description!
�5
PropertyTax IDlt: Lal Na.
Site Plan Name: Block No.
Project Name:
Setbacks Front - - Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
''o Iii� Id"' - NtW 4 OK 3.s -rove 1c s56r, • OL 545am W/
6rjd ( MooW i 14A c wool
,fir qWV I1Wtl *-I,1&)(SkM11-04,?-
CONSTRUCTION INFORMATION:
o wor to orme un er t s permit—c ec a appy:
HVAC 11 Gas Tankas Piping _Shutters []Windows/Doors
Electric Q Plumbing Sprinklers ❑Generator 0 Roof
Total Sq_Ft of construction!: Ft.of First Floor:
Cost of Construction:$ A_ db. Ob Utilities:0Sewer OSeptic Building Height:
OWNERAESSEE: CONTRACTOR:
4
ll
Name Name-
Address:_ Company t
city: State:2, Address• �
Zip Code: 10! _ Fax A1!A -_- City: •re ��L ._ _State:Ff-
.
Phone No. q�3"��1"qI(D� _-- Zip Code: XIQ 5 Fax: -771"��b ?,��
E-Mail• Phone d 401-:9 41
Fill in fee simple Title Holder on next page I If different E-Mail: Y\
from tha Owner listed above) State or County License:
tf value of construction is$zso or more,a RECORDED Notice of Gammomceeneeet Is r"uhed.
05/31/2017 10:27 7724663737 BOYLEAC PAGE 02
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
Df s16NE ENGlNEEII: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City. State-, City State:
Zip: Phone: Zip: Phone-
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City,- City
Zip: Phone: riip: Phone-
1 certify that no work or installation has commenced prior to the issuance of a permit.
5t Line Goin makes no rap on that is granting a ppeer�mnv ill aorixe thepermitheld to build the subJect structur e
which sin can ict with an pp�Home Owners Association es bylaws ora covvenarft m restrict or r0 It such
structure.Please consult yr i your Home Owners Atsodation and review your deed for any resoictians which may a�ply.
In coiWderatlon of the grmnting of this requested permit,I do hereby agree that 1*111,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lude County Amendmarft
The fallowing building permit applimUons are exempt from undergoing a full mne-urrency review.room addldwkl6
accessory structures,swimming pools,fences,walls,signs,screen roams and accessory uses to another non-residential use
WARNING TO OWNER:Your fedure to Record a Notice of Commentement may result In your payfng t Wo for
Improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection.If you intend to obtain financing,consult with lender or an attorney before
commencing work or recordingypyr Notice of Commencement_
dx
Signature of Owner Lessee gnature of Contra cense alder
STATE OF FLORIDA STATE OF FLORIDA
COUNW OF - T_ • _ Cl COUNTY OF
The for ng instrument was acknowledged before me The forming In ent was aftoWedged before me
thisday of �j�. . 30�by his 112tday of zo_,.eby
kA" a ( 11
CV
(Name of person acknowledgin ) (Narr+e of Person oder ng)
(SWature of Notary ublic-S e of Florida) (Signature of Notary P -state of Florida)
Personally Known OR Produced Identitlmtion Personally Known OR Produced identification
Type of Iden ration P d" type of ld
,.Ullry„
CMRIBTINE Cr,_Qfi EGG , ,,�Y CHRISTINE CONWILL
t6ilbb
Commission Public Floc Comms o Public•Stats(9dr*1
Commllslon M oG 017639
• Commissiw N 00 01 711ft AZM Comm. r Aug
VGWj!A Oandtd thrcugh National hoary A11e,
Revised Q IM A0^ad1r momaI Nary Atsw,
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW RMFW
DATE
COMPLETE
INfTIAIS
05/31/2017 10:27 7724663737 BOYLEAC_ PAGE 03
RM ENERGY CONSERVATION COI1N
Mandatory Duff ImMecdola CerftMtion of RVAC Cham-out
trot use%Wm W of ate dust s WtW MVAC wham Im boad replwW(ftWw+10L4.7,L1 SSsM21
F:Strs*�WtrA�4dmm; 1 $5q A-ca,i
,urltdit m,. a� caufft
CKT. �b(t - Pam
ZIP:
ZIP: �,�i!� _ , Rhol hupertich data:
I Cafft thlit 1 hwde hued the duct work modated with HVAC urdt mftTQM by the Perna Umd
sbavfr acrd found it axrrip{i�F Iwidt the requirwnwents of Sectla�t aAi,.4.7.7.1�le�dlcstad bffbws
0/1 here rmWW,ftgxktlftdutfthM been swtlad using mint nmil trtoreta or axile
approued aquivalent-
o pucks as locadtd wlthln axadltimm" too*.&Secliort 101.4.7.1 etaf$05W 1)
o The JaInts or smm sm alresdf stolad wkh fabric and mns*(Smdft MA71.1
exr-Ali 2)
o 9ltstem was teumd(sro+e Mow)and rspWm rare-meffe a;Grp:—(5wdm
I tA.7.1.1 otos r 1)
Xslgttawre:
Contr=Ws WOW 4 • -
0"uaerwa ik 0-&c 8 t 8 E
t cartiW i hm tastad tlw mmis *aIr a Mdbutkm s0mm(s)referarMXd by the pwm%Umad abov -st
a ptraam dH%ru*W of 25 Fast O.if3 tn.wx4