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HomeMy WebLinkAboutBuilding Permit Application -"D (CABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE AM c'D • Building Permit Application IPhc-.- 772 -62-1553 Fax 4�A62-1,78 Commercial Residential P?M1TApcLICA'TON POR: _)203 1 nkolnv r i Eeyu ' C ► t Ledl SI-e=a-N2.=e /] /� ��r�,�..�� Block No. w 6e, cks =ron: Back. Right Side: e�,Side. '1 ft i� Adcmoraiworkrcoeoe.Corm un er this permrt-check all that app,- (� MeC 2^tC2 -Gas li:^.k Gas Piping Shutters _✓:Ninticws/Doers °,em :ng _5penkter _Generator _Roo: 7„rt Sc _ .� S;ru Cicn SC `t.CT rirst`;Ocf CCsi Of l o-��ios.S �W Utilities. _Sewer _Se_`, Na-- Name:_ _C Company Ir;n'i E+'-`..���;se .a E.e.e-rA 1>5a = c S*ate tL Address: i:OP To7cba,:,Y Di 'io Cede. (� :ar �� City _oiNai, �e.ch State: FI nnp-e No, 1 {�-l.l�p�_l7_�f l '.p Code: 32937 `ax. 32I- 777- qZ34 -2i: n,�`� Prone No. 772 337-'l470 Fill in fee simple Title Molder on next page(if different --maim. Nic55halnn alp vai,m _aM cpm the Owner listed above) State or Cou�T,L.Cense- Y vaiue of odnsimucron is 2SW or more,a RECORDED Notice of Commencement is required. '.:IN ---� - ,� �'^� ^� - a-'sem I vj DESIGNER/ENGINEER: MORTGAGE COMPANY Nc Applicable ! – — N2 Name: it Address Address: _._ Phar:e Z'p Phone FEE SYMPLE TITLE HOLDER: _'�o; Ape icable BONDING COMPANY: —Net Applicable Na:^e. 'game 't -'c."255 AdGrcSF �!tb - City. Zip PhC, c Zip `__ - w ♦ - ns c Ic D 1 25 T-'+ 2- ,O J Z. S n e^ Oer^'I r. I - -e C makes no a'e-niKfll aLi zhe per-, holder to OUIc'}te subJecr strUgzure 5 , l IC-with aC b- = ie no: E Ownel-?socibn rules,Oy aws o -nc o en nts that may eSriG or prchiblt cuch l Y - YS- - �It w.- cur ro- Owrars c cot r'cv ane Fay.yo domed ro-any esrcuons wn+ . may apoiy r er -f,^ -he work :g C' .^.2r.ay;g-ee..2.�A'ilt 25. i.pe.. -., - _..-.t: GOES rd$i .i: I oun y n'f •+O r?e'!�. _ -_ s 2rc_xe -_ -o .uedergoing a full;cont: rend,evew. ,Oo-adcmons, _r:2550f1 S7-.tc::'?5, sW�-'T:i c;-cc!s ri wars,signs scree-rooms and accessolti uses to another nor-resideniia,use WARNING i O OWNER_Your failure to Record a Notice of Commencement may result in your paying twice Tor --._– o.r prcpery .'.Notice o`Commencement mus be recorded ar:d pts-cd on the jobsite 1 - h - r `yrc ln[e-d : ^tai❑financing,cclnsult wits I rd r or 2r' before - '10,Ccm^e,-:ceme^ Avg lll�I 1 _Sig^-*:;-e a'�wre" es�ea'Age_• S.gn�:ure c �3^r-s�,cr'_cense^o+oe- STATE©��L STATE Of FL0AR 1QYd COUNTY o>= + rr COUNTY OF i�if� '.- y '£" "--�.�s-::.,.eez�' `c _ , , �- oinglr -_-�-�r�n. �a�s ectnewletliec before-•,e 20 I � { i 1 pR F oc:.cec+don.ri cat cit I nil 5. 6m X kne 2QS9 _ zk EXQtsuC BnodedThloWlarlPahrclini ^y F::.?� 9pndatiTtvtMtary PuS'c U�"-b�YrfB19 #3 k'S =RCtiT CONING SUPERVl50R -LAN5 VcC;-A_lC1V SEA,,JRT•_E NIANGRCV`= ! COVn _g REVIE%ev REVIEw R_Vii:W R llE'w REVIEW REVIEW EOMPL-- N 7i.4 ' e m Z Z Z Z Z Z z Z Z Z Z Z Z Z z z z z Z •? F m a 4 c o a a P a e e a c o o q a a © e r o R � J a e o o e o 0 o q o e t O N a O O tl O O O !+ N N N N a yif e 4 LL 10 ® flJ W P 0 ; o�e0 d m � w O ak � e tlS t a 6 csi r O'c00 Y T b® in�3rn O � N O x CJ g0 a °0 € # Ea v e u9 v m 'e m aa � � � w Ti 3y em a 1 1aq m E ri a p ap1 y o � N u 0 N ]Z m q A O a %a a0 t N 6 0�.o an w m 9 ® Cg �gy Z UN a - m V a y v o a = 2 Owl' d � of a a ZeN.0 _- 3 `a O p 00 2 a y W JL Q O 1 a CCS S nch im E �_ c r E W o O ry 0 zm r�r • X i m m r m m m m m m m r m o n m i m m m w ao w m m m m n u00i m N h m 'n m }k (j f ! q \ z ) ) \ ) / i } }\ {| 2� /} |( <— (§ # �k OD.2 ! - k f \\ IL) \{ \ - / ) \ o !£ ) k ! #§ j � $ \\