HomeMy WebLinkAboutBuilding Permit Application 11/21/2017 23:32 7724663737 BOYLE PAGE 01
ALL APPLF eLE FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: r Permit Number:
.4'6 - o MONEYS
Building Permit Application
PWning and oevelbpment Services
Building and Code Reaulatlan Division BY: ........
23W Vbginia Avenue,Fort Pierre FL 34982 ......
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 14 8 q!5 �'U.C11Y1i► P f C� , L 351
Legal Description aAi',h U.$
Property Tax ID fl: 0 4d — O b d—d Lot No.
Site Plan Name: Block No.
project Name:
Setbacks Front Bade: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
reuw 3.s -fDn� 'SV eR A-C sptit- sc ftcrn, Ltmwx .
C( W1.5�( 11�od2� i� 14kg 041 anol. &ir&`141ef AOM* 6139 '46 U.MV a'a-
CONSTRUCTION INFORMATION:
workSC -g0 orme un er s perm -:c a app
HVAC Gas Tank as Piping 06enerator
Shutters Windows/Doors
13 Electric El Plumbing Sprinklers Roof
Total Sq.Ft of Construction4500-0o
, Sq.Ft.of First�oor.
Cost of Constructkm:$ 45 0 0.0o Utilities:L.0 Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Name:
Address: jyjQ 5 '7t gLA Sj-_ Company:
LC lile A41-
: rvwpitrm I I State: Addre
Zip Code:�„ Fax N City: Stater
Phone No.7'1 Y Zip Code: _ 31+q5 ----_-__ Fax: --n X-446-87 37
E-Mail: Phone N -
Fill in fee sanple Title HMder an n ent pager(if different E-Mail. Vll t✓
frwn the Owner!Fated above) , State or County Ucense:
If value of eoristnrctiori Is SMW er mere,a RECORDED Notice of Cwnmancmwmt k rrquhed.
11/21/2017 23: 32 7724663737 BOYLL PAGE 02
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNS ENI WEER: _Not AppliCable MORTGAGE COIIAPAINY: Not Applicable
Name: Name: _
Address: Address=
State_ Qty: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOI DEW Not Applicable DQNDIN6 COMPANY: Not Applicable
Name. Name_
Address: Address_
Qty: City_
Zip: Phone_ Zip: Phone:
I certify that no work or installation has commenced prior to the kwatce of a permit_
StL�We Coun makes no that is gra a rdt viii the holder W build the subject s re
which ES let t�Cr with ar�y apptimb a Home Owners Astz ion rules, ora cwenarQs float may restrict or prohlbtt sued,
btructwe. se consult with your Home Owners Association and review Vow deed for a"rr"trictions whk:h may apply.
In constde ation of the granting of this requested permit,I do hereby agree that I will,In all respects,perform the work
In Accordance wfHt the approved plans,the Florida Wilding Cedes 8M St.tilde County AmertdrnoTts..
The faltovAng buxding permk appllc=kwu are empmpt from underynt%a fun cmcu nwev revianr.morn addtdortis,
amessory structures,swimming ponh.falces.wags.signs,screen rooms and accmM uses to wKOer non-msidenttal use
WARNM TO OVWWER:your fW&we to Record a Notice of mW result in your paVbW twke for
Improvements to your property. A Notice of Commencement must he recorded and posted on tote jobs"
before the first Inspection. If you Intend to obtain financing,consult with lender or an attorney before
commencing work orrecording you Notice of Commencement
- --KGs
signature of 5igr ah"of contractor/Lfaense Haider
STATSTATE OF IFLMDA
COUE �DAqi rCOUNTY OF, ei• wt�e
The f mens acknowledged before me The ktstruntent dtnoMAedged before me
this 7 day of 20 L' by / tills Of 20—W by
(Name of persoh afto 4e*ng) I of perom a&rxMlw* )
Of
- �. -.
(Sigrature of Nota70R
State of Honda) tswu�ufr of Nota folic- of fiorida)
Personanown
Personally K , Produced ldentKic irtion
Type aF
Type •» „ CHATPW 1_,7NWELL N%lry PW fc •VAN a F*Idi
Comm %cosy PubolC . Si www Comm .— "Mal n 190 01101)
1raIRlArrrrlun N tit Ry Cww-ExOM Aul 21.2020
My Comm.Exportµ9 21,2010
Revised
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW RE=VIEW
DATE
COMPLETE
INffIALS
11/21/2017 23:32 7724663737 BOYLE PAGE 03
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