HomeMy WebLinkAboutBuilding Permit Application 01/25/2018 03:06 7724663737 BOYLE PAGE 01
ALL APPi 1C INFOMUST BE COMPLETED FOR APPUGTION TO BE ACCE"w
Date: --�-� Permit Number:.)
Building Permit Application
Planning and DewrMpment Sens ,
Building and Cade Regular JAN 2 5 18
2300 Vilyinia Avenue,Fo lerce FL 34982
Phone:(771)462-15 Fax:(772)462-1578 ommercial, Residential
PERMIT APPLICATION FOR: TO Select frpm dropbox, click arrow at the and of line
PROPOSED IMPROVEMENT LOCATION:
Address: l ,ff03
Legal Description: 1AWOOL&L - Lkn �)- 9 �1 2-1
PropertyTax ID#: y 0 00",�- Lot No.�
Site Plan Name; Block No_
Project Name:
Setbacks Front Beek-_Right Side:_Left Side:
DETAILED DESCRIP"nON OF WORK:
Y
r)tw �1 -byl / l5 SES5v5 M wim
P�ad2( 9A WA4 8 _ rnoo * ABN P-?4 1 I
CONST CTION INFORMATION:
grial woto(
rine un er s perm -c e a appy.
HVAC Gas Tank as Piping Shutters 11 VAndows/Doors
Electric U Plumbing sprinklers Generator Roof
Total Sq.Ft of Construction:_----.-. Ft,of First Floor:
Cost of Construction:$ d UtilitieSewer OSeptic Building Height:
OWNERAESSEE: CONTRACTOR:
Name Name
Add r Company:
�y Addre : N D5 UYh
Zip Code: Fax: Clty: 7 f State:
Phone No. Zip Code: CJI Fax: 112- -4� -3737
E-Mail: Phone No. 7
Fill In tee simple Tide ilaldw on next pa"(it different E-Mail:
Imm the Owner listed *bow) State or Couhty License: $1111 U
H value of construction Is$am or more,a RECORM Notice of Commencement Is raqulmd.
01/25/2018 03:06 7724663737 BOYLE PAGE 02
SUPPLEMENTAL CONSTRUCTION UEN LAW INFORMATION:
t]ESiQN EN6iiNEER: Not App
Ficable MORTGAGE COMPAW.- Not ApplICOble
Name: Name;
Address: Address:
My. State:� W. state:
Zip. Phone: Zip:-Phone:
FEE SIMPLE TME NOIDER: _Not Applicable BONDIM COMPANY: Not Applimble
Name- Name:
Address: Address:
{qty: Citi►:
Zip: Phone: ZIP: Phone;
I cerHty,that no work or Instaiintion Inas mmmmmd Prior to the bm ance of a permit.
St tie �vy makes withno that is a it 11 thercoMenat"holder to build the subject
s ruaturre.Plis ease consult your H �'�review 1 r ions�whi nw a .I such
In comoierstio n of the granting of tf cis requesttd permit;,I do hereby Wee that 1 will,in aft respects,perform the work
In acaardsm with the appraved Pians,the Florida Building Codes and%retie County Amendments.
The following building permit applications arse exempt from urmkq;ft a full cora.,urrenty review.room additions„
�strudwe%swimming per,fences,veli,signs,screen rooms aM a=wsory uses to another non-residential use
WARNING TO CIWNM:YourfJrBr(rrva to Record s Na tko of Con nnencattra+nt miy nautt Invow w"11' twiire for
lm rovements to your ropsrty.A Notice of Commencement mast be recorded and posted on the jobslte
before the first Ins if you Intend to obtain ffnandriL consult v ftt�lender or an attorney before
commendn worts or recordin r Notice of Commencement
Sl�rnstum of Own Agent/
9grnatur+e of amiracwfflwie HoWler`
STATE t STATE OF RMDA S-,
Ccw m c CDUWY•Ol-
The $o�ng lnstrn�ntrtrrY was ackrro+wled$ed befcwe me Atte he a nt was acktenwled�ed infers rune
this Q�day cxf'i-11t11tt1U 1/Y . 20 W by IrCm a _Idrgby
Cho It�a
(tiame of person acknowledging) (Name of persona ��)
(5ilInature of Notary io Firrrida) (Signature of Notary Pu of norma)
Personally Kn P�Orns
T of kkntfi CHRISt � Type of N' Prod IMA J COW"
Commission 11Na
Na '•'
CommisSu��y'`(;P"A.,34 Comm • Camolmo.O Ik
nrt , �•1'�`� , ;t.2020 1 . xNMiQ���
Remised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PIANS vEGvTATI(!N SEATURTLE MANCROvV
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE •
COMPLETE
INIIUAIS