Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAboutBuilding Permit Application WV MOT LLOZ/LT/OT
ALL APO CABU•iWO MUST BE COMPLETED FORAPPUC.ATION TO HE:A CPT90
1., - perm►r Number:,�,,..���., 1 !.�
Rate;
low
RECEIVED OCT 172017
Ootid-Ing:Permit-APPOCA100
P400)§ON lFeaelapme6f-560105
Bt#ldlRq i{rr(l Cndc It 9u)(7 0i�7lv;:lph
(V7n3i.tfaRvenuc,.fork. ier.�e. k.3�i�1
Phone: 47a)44 221553 Fax:(772y462'•3;57 rail rtt i°ci�l 'Ftes►dentiai:
POMITAOLICATION FOR: 7f?.Select'fraM drbol)Ck,Glick arrow:iit the 4�nei 6f'lis.0
Property Yak ib'lf:s�'��' •• �f t �—_ ,_ . lcrt Na:.T—=�� ,
SiteFlan Name: _. . .— .� ..., ....,.., 81ai:k•RI4:,
Setbacks ' F'rorvC_,,_ Right-Side:_.Left Side:
. i duns p-vivie.
rz+o a wor ti)
rmfa un er. sperm. —c ec app Y%
I.�Iti•Y3tG Cas�aCik .aS Aipin� Shutiers j '(Wiru3avrs�l�nars
Cbee@rlc U P[ir"Mig []-�prmkiars 50v.'�tof 1.�.,�•R00. pikCn
Total Sq.R ofCanstruCffon: SQ.Ft,pfTirst Floor-.
Cosi°of Can9trudtiori;S
utilities t 5jwer 'Septic 9111160k Hpirhts
Namo. Name?.
Addre5S:
State; ,address:
F C.ity: . • ... �
r; Statin:
i dip.Code: Elk ... City, �..
Phone Nd; ZIp:Code, Fax`
Ppane Nb, " I
01 in fee simple 7'itle-VolderdohfttPI@9R•(!fAfferQfvt ( .t�lialt: ,• ~..
1 State ar C134 }+License:
E{t►hmi:h���?u+rnerii�ed a4�gVe) � .. ..
tf.imtUeai tVastrpctrnrl 9�S28tt.0 ar mdt+9,a•R�CeRDE[T tlattce ul CommeacQ aRc is r. Ujr d.,
.a'd
WV MOT LXOZ/LI/OX slot
DESIGNER E{e MWEEK: 4..Not Applicable Rt r)gT6AtjE•ctDMRAf+1Yr 'f'ti fVot QpplfGabfe
Name... . . Name-
City.-
ameCity: St�tQ: Cid+:ro ...�5tate:
ZIP: A on© Zip: Rhone:
FEE S3tlllAiE Ift'El~.F4ip1pER: _,X NotApplIcabl'eI0011lta:9,tD9NpANY: Not-Appficabfe
tame• Nn>:tiec
Address- �,�--�� -... .. -W
Zip=
OWNEW,cOii`I�A TQiR�SFFt[>f1Pft:'AAPEieaLipn:lshe�e Ymadeto©hi lit P�rintt,'i}:d�the.work'and'iifstaiiatiuf?'aSindlC2i�d.
t s:astlt�+tfrdt no Work ai+instdJEttti+�tr hax'CbrtimcniGetl•prl'oF td th a I'i&uante'ar�pprmrt.
I uci�Count makeg no re rage..�tatl6r~x}i�.t{g;8rahtM a: :a iniG' lii'authartre tba aCn Sk ilpl�f�r xp Etliftd ffep.subject Stftl,Cty/c
�vhlGhis In�op Ictwitti,ai apnllc�ndA HORtD Qwnee;lts�tan rues,by.awsor,in r-covenants that rriiy'rttastrfct ai'•PW ibltsuch.
strucCurc'Ridt SQnSUICIncS{t.Yourlloftle�lMta9r.�AsSrr f4riandkwt{ yobTtlead o,.ati resrriicibnswhrch•'xnaV'aBPly•
rwcolrsfdera#Qn Rf the gr,wttiirg..of thL5 requested', rrrat,:i da he8re.6y a$re®'that! 1fi,In SII ras>h�Zts,perNrm thvwork
in-actord'&ttce Wifh tfrd:8pprbved rilaosi the'Fiarida 9uftding.Godes and st.Cu66 cot,nry.Amentlrrterrts.
The following building permft:bppptatians are exempt from undergo(hS.aU9'concwrency'revlew:raps»addition,
aecssssortif aiructur�s;sveitnmrn�p604,fences,ivak,s19nr,screen rooms and accessary usevici another npn,residemia3 use
WAfININOTO dWWW V'aur£altum to ftecard a N ittet:(f Ctitiimencoment May resuft:itr ipur p4Vft tWke fPe
irn,rov�riipr4 to y'purpraperty:A..tde�ljcP qi Corttm net!miept:Most�be facoided and!?osteo gmth'0 j0bsite
befiore the fgr'st ioi pectiaa,if you:trfteY.d td bbmin flri4n&i&consult:With(ebdAr or.atl uttornpy.f efore
commenting works retordiri'• o f Ndtke�Cairrrn�n mf«i1t... r,,.
SignaturQ•pf+�wei�rl:t:ecsae%r•,�r±tractor a� int fop pivp�r""';:$Ignatyre q onE,raEGir(LiccnsA•Fiold®'C'
TATE.-OF'F[ORtpiR STi iE f3F'F.LC1 AA
0 :COUNTY OF
.a p h1r ingihstttr @tY 5 ick pisrtedged hefvra me. ThA:f�lr 4iggfq�tC.1491 qAt-OS., KiSpWle ged bQrato'm q p
Q"•' is. . aP . ZO.f tt this 1' de pfxqo
� ' 2tl 5Y 'a
w nm . 2rson7no5king.Staternek of der ogmakTrrgsfatgimahf �°.�
er6crnallygrit1w 1v� OR Ftbducdd Identfficatlop ,_„�,_ i�lf nb e �OR Pi4ft-ed IdPF)%IIrIt0on
r at9o'r'; Type of Joohofi� 'on '
Produted ... .. •
~ Isignotur 4f N" ry public-Sate of FiWdA i ¢ {Sfgnatuts of fJ4idc}r Public State nf:0iar�da
:s camrtiission�fVo, �^ . {Ssitlf I,t ommissioalVn T„ �^ (5&aT}:
PtVIEWS FRONT YZOMNG• f sukgvlSoff FtLANs ;'VEGGTAT-i&N j SMYURTI-E MANGROVEr
COUNT,% REvlt I R'�V11 w R VIEW HVVIEW i REVIEW FrE4�li U9t•
�..wr
CQMPiETEpLL--'•-----._ ..�
Rev..8/7117
:ag