HomeMy WebLinkAboutBuilding Permit Application H00 cSrt+ 11150 I'2.
All APPLICABL INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
'e--.7 Rumor _
i
i
Building Permit Application
Phone ;772,. 92-1553 =ex i'-_ -. TcI, Residential
PlvRMIT AP?,'CA.TION FOR
1)k,, I om q,,.iI .1+.IP_anh Cn
a
�s �,/�op0t la s oR 5°�Uu w 3S�
'%'V
ON
Ta. _ u U— aJlL=1l'V�R/�0 Lot No. I
Site Dian Name Block No
Dr3 e, Neme �b.1�nd �e --- - -
Setbacks =root Back Right Side. -eft Sitle.
14aditfonal work To be ne-oled under n,permit-check all mat apply
_Me'!'anica! Gas Tank =Gas Piping =Shutters Windows/Doors
C:a
tipnnk!er5 Gcn2ra iGr PCJ� I
!>C. :.'u .,cr -Q -t C
us,o*Cons,,con.S i/t;lities: _Sewe. _SeptiC Building Height
Nal- tuild Name Cr!trf�,-k
t. Prccf;,a-
Aepressn(+i �[_— Come
-"T ica>=- Address. i:'
°i Cede &I Irk Gty IM;�r_., - ---- State.-1
Dnone R .o -�L '_ip Cor,- - _ -ax: 3Q- 777, 4Z34J
;-Mai, Pnone ^l'
Fill in fee simple Title Holder on nett page(if different '_-Mali
from the Owner listed above)
0 value of comt<rvcdon is 2500 or mot,a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER MORTGAGE COMPANY. NOT Apphcaole
N2.—e Name.
Address : Address:
crr. State:
-, phone Zip. Phone: _
FEE SIMPLE TITLE HOLDER: _No; ='oellca bye BONDING COMPANY: _Not Applicable
Name. Name
Address Address
Clte. City.
lip. ohene. - Zip Phone
1
__ .'v na: wc:t u .�tallar'o�r na._.,oenced Prmr to tine ssoance of a Dermic.
< Co +
m2kel no p nta d,-,a,s r ing ne.m,_ ,,j aun,onze tra ae: t old r ro b ild the subject st Dcute
hirnu-a '1Se�'Wstlt w:,Your r,F-.Iom=Ow 2r>..vO�S Yert canCrue✓=w Your deed fora vnresriot'O swm1cc aY rPvlyh�bit qTh
t co'.s ae a' he gg c" .ni G es c 2r-. t C -Erebv agec I'ai w'lll r all aspect-perr0rm the aOrk
r�ciDraar_�m a=ppn edar _a Sc Id-ng de,and St as Cou q Ame,dmer
-a oltowmg eerlding oe. .atchra,a.s e rxemD .rem undersaing a roll concur. ncy rev,ewrad,aadSions.
cazzorY Rr c.Ores,SwLr,m ng Doels,f"t".walls.suns screen roo16 alld accesso,uses to zndrher non residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
Improvemens to your p:opa.y A Notice of Commencement must be recorded and posted on the jobsite
before t`amspecion. :f Yo'Intend to Ootam 4inandng,cc
ns t.ofrh lender or an attomev befor-
[cmmer - ors or rec�rdink V 'o _of Commencement - _—
_ __ r.a �, e --
STATE
_ _<_e=_'Aee� '
STATE OF FLOgipA_ _a� STATE OF FLORIDA
COUNTY OF T]AL!I __ COUNTY OF CXYAICL✓U
- - - __ ^•-< < ^� O __ _ azo Jr.4Q
l -
25
_-
}I[NN(F 3WATI
SIGETI
FF244&% --mislp f NN'>QFk R4yn`r^Y=aF22409189MYC50NIN }P55
EXPIRES:June 25,2019 '' • . am,'+. wan. �LNewAdt
SLP RVISCR PLANS AEGEIATIGN ' SEA TURTLE MANGROVE
PUNTER REV17 A REVIEW aeVIE'W REVIEW REVIEW RE IF%ty
`-
CMPL_ _
N. 1A