HomeMy WebLinkAboutBuilding Permit Application 12/19/2017 00:05 7724663737 BOYLE PAGE 01
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ALtAPPIILE!INFO MUST BE COMPLETED FOR APPUCATION TO IN ACCEPTEQ f �
fie• Permit Numbir
fIC Building Permit Application
Ptannfng and Deerlopment Senrfces
suildina and Code Repuladan DlvWm
2300 Wrginfa Avenue,Fort Pierre FL 34M I ;;
Phone:(772)462-1553 Fax:(772)462-15713 Commercial R�esideritial
PERMIT APPLICATION fOR: TO Select from dropbox, click arrow at lite end of line;
PROPOSED IMPROVEMENT LOCATION: I� j
Address- 3 5 II
Legal Description: IILot
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Property Tax Id#• '� l 3�i "(�Oc! - i� tot No.
Site Plan Name: II Block No.
Project Name:
Setbacks Front Back: Flight Side:.Left Side: ()
DETAILED DESCRIPTION OF WORK:
f 5 5 EE;?,t
CON CTION INFORMATION: ;#
Additiql1al Work 0 D nA Orme un er is perm _c ec a appy:
HVAC Gas Tank as Piping Shutters �W;ndowsjDoors
ClElectric Plumbing Sprinklers ElGenerator i Roof
Total Sq.Ft of Construction: Sq.Ft.of First Floor.
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Cost of Construction:$ }�}- } } Utilities: SewerSepti iI1 f Building,Height:
OWNER/LESSEE: CONTRACTOR:
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Name Name:
Address• T Company:
qty. State: Address• d.
Zip
Code. Fax City: �) State:
Phone No: 'I�1,�-' - Tip Code: � �4�f *ax:�"1�a•! �Q- A 31 T
E-Mail: Phone Na. i f
Fill in fee simple Title Holder on next page(if different E-Mail. 1
from the owner listed abore) State or Co my License: �kC.1 i$�o.
N value of mn:m e"an k$2M or more,a RECORDED Notice of CommenCOmant Is rcquirtd.
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12/19/2017 02:35 7724663737 BOYLE PAGE 01
SUPPLEMENTAL CONSTRUCTION UEN LAW INFORMATION: 1
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DESIGN NffA!' Not Applicable MORTGAGE COM1PANy: Not Applicable
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Name: Name:
Address: Address:
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y; State: City --- 11 1 State:
Zip: Phone: Zip: Pholt�le
FEE.SIMPLE TITLE HOLDER; _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name: 1�
Address: Address. II 1
City: II 1
zip: Phone: Zip:. Phone•__ ..,,, -- -
I certify that no vuork or Installation has eommen6od prior to the Issuance of a permit.
St.!uqe Coen�y makes no rep n that is greMing aperm R li a =0&e the p ba build the subject aperture
whiCft(s m oor�fllct with an ppl�Home 4rrr�s Association rules,byaWS ane covenants that may restrict or prohibft wdi
structure.Please consult ww�i your Home Owners Assoclation and review your deed for ny riestrictions which may apply.
in consideration of the granting of this requested permii,Ida hereby agree that 1 will,in all nom,perform the work
in accordance with the approved plans,the Florida Building Codes and St,Lode County Amendmauts.
The following building permit applications are exempt from undergoing a full cmxnrrenq reAeww:room additions,
accessory structures,swimming Pooh,fences,walls,signs,screen rooms and accessary usesto anoth1 1:er nowialdendal use
WARNING TO OWNER:Yourprop".failure to Record Y Notice Alf M .I. m'Y t ft t1Mke for
improvements to your prop".A Notice of Commencement must be recorded andposted on the jdbsite
before the firs Anspection.if you Intend to obtain financing,consult With lender or an attorney before
commen&j work or recording our Notice of Commencement. II i
Signature of Owner Ager►t/ Signature of Contractor/Li icense Holder
SPATE OF FLORI7T. STATE OF FLO [ . 1
COUNIM OF �.L1 P COUNTY OF ----
The Ding I merit was aclmow!W*before me The ng hatrument l adcnov ed before me
this�day of 2a wby thtr�`=�of2OLj&by
tiC. Dc� �• a
I (Name of person admnwledging I (Name of person acimm ledging.
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(Signature of Not9 ub -State of Florida) (Signature of Notary P -State of RMda}
Personally Known NgstMNiURO M Mw! Personally Known
Type of Idenl3fl TVPe Sig$MI
"Well"•040411$! it li C9 1"W-0 60 017839
Commission No. Dili Comm(laMl'!Avg P j 2020 Commission No. Comm.E> Jai 21,2020
Monad tb tlatlont+i101HyDan. , carded 1hr0u�i106011 Nmsry Alto•
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Revised 07/15/2014 I i.
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION ;SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE j
COMPLETE
INMIALS
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