HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BECOM PLETEDFOR APPLICATIONTOBEALCEPTED
rl Date:dune 20,2017 Perralt Number:
Bui Iding Pe rmit Application
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- '-Baild4undCOdeAegaluh$ADvisid-n — - -
2300 YrginivAvenue,Fait Pfercr FE34182
Phone:(7721462-1553 Fax:17721462-1578 Commercial X Residentlal
PERMITAPPLICA710N FDR-, Eleclrical - -
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Address: 7550 Pnlill Research Road FI Pierce,FT_34945
Legal Description: -
P roperty Tax 10 9:2319-900-0001.000.3 Lot No,
Site Plan Name: Block No.
Project Name. 7CERDA SUNSHINE l(rFCHEM -
Sallracks Font Back: ftht Side: left Side:
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TEMPORARY POWER POLE
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AC10Ifr WO to a er me under
rlbispetrntl-c eckalf^p r
Inn�IHVAG �-- GasTank ❑Gas PI ping _Shutters Windows/Doors
l�Elecizie El Plum Ving L_JSprinlders Generator Roof = Ronfplh
Total Sq.Ftof Contraction, S .FI.of First FiDur.
CotIofCOnstrucdom 50D•BO 1R11illes: SewerQSeplk BuildingKe7ght:
6,i=14-
Name}_ z-< 1( LC Name:DRYIDNEL-SW
Address: z i71 11).'. t+: r Ji Coinpany:.ELEGTRASERVE
City: i r`%f y Slate: FP.P
� Address: 9M NORTO1tJT PARKWAY,STE M
rs WEST PALM BEACH FL
Lr� 21p Code: Fax; Chy: Slate:
m Phone Na Zip Code;33407 Fall: 681 72D-2653
m E-Mail: Phone ND.754-20S2ffTS
Fifl is fee simple TitFe.Halder an next page l Itdiffererit E-Mai'ADtAIN@EL•EGTRASERVEWPB.COM
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from the Owner listed above] I State or Cawi[y license:
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If value o f construcOun is MDa or more,a IIECORDED Noi lse Of CDnmi encernent Ss required.
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DESIGNE ENGINEER; _Nat Applicable MORTGAGE COMPANY: - NotAppflcable
Name: Na Irie.
n� Address: Addiess:
Oty: 5tate: City: State:
o Zip: Phone: Zip: Phone:
-o- - - FEE SIMPLE TIT.LE..HOLDER:_ • NoiApplicable BONDI NG COMPANY: NolApplicable
z Name: Name:
Address: _ Address:
City: City:
Zip: --- -- - - Phone: --- 21p: Phone:
I certify that no vn rh or installation has commenced prior to the Issuance of a permit.
- _St.w6eColin Imakes norepseseotallon%hatIsgraringapemtilwill authorize the permit holder to,build 1hesWJect51yuclure
which isrn con lctr+lth arty��ppplhata'e Home OwnersA55oc ation rtifes,bylaw or and couerWALs that may restrlctor prdribitsuch
structure.Pleasemnsukva5hyourlSarneOwners gssaclattonand miewyour deed for enYresrdctioluwhkfimay apply. -Inconsideration of the granting of this requested permil,Ido hereby agree that I swill,in all respects.perfarrn the work
h accordance with the approved plarn,the Florida Hoiiding Codes and St-Lode County Affaci rdnrenu.
Tine following buiidmgpermit applicatiorss ase exempt rmrnundergoing a full mncmrenry revsew:roamedditions,
accessory structures„stwlnn ning pools•,Jennzs,%wells,sigos,screen rooms a W accessary uses to another non-resldentlal use
WARNfh1G TO OWNER:Your Salfure to Record allotice of Commeriminent ayresult in your paying twice for i
irnprovemenis to your property,A Notice of Commencement must be r corded and posted an th bq;ke
before the Hist Inspection.if you Intend to obtain finarxing,consalt fend r or an attorney f
comme cin work or reeordin our Nothe of Corminencemenl.
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Sign"u d Owrnrilemee/Contladur as Agent for Ownef Signature f ConUaaorf license Holde n-
51 ATE F FLORIDA STATE OF FLORfDA S
COUNTY OF ST_LG Cfc COUNTY OF:rusrv=_+cm t
ThefogoinghvtrumentwasacInaMedgedbeforerw The forguinginstrumenlwasadmawiedged'before me
this 7Zdayof 12017-TbT this darof .20_by
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A -5" laAbt�- tuwra WZLZDH I
(ham pe son owledgingj (Name of pe_ or acYnoiledgingl
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Notary Psmlic-State of Florida) (Signa[na- o Notary P t orkla}
Person-K Known e n a a _ onalty Known M ORPraduced fdenpRdilon -
Type ofldeniNlcaUanProdu hbngi'Mcb Ty of ldentdicatl
n�fi yrs
�� tin S r d Rnrtla 1 I
Commission No, 2- es' ( jl}sesHaam9 C nr*si.No.a ?J3'`• Fr Rdswim}"`M7'
co ss X GG 16C77x
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m Revised(171151 A i I
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEAT.UATLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE — —— — --"- -
a COMPLETE
INITIALS
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