HomeMy WebLinkAboutBuilding Permit ApplicationDESIGNER/9NIG INISSR:
Not Applicablei
N OIiTG AIC 8 COMPANIV: _ of Applicable
Narrle:
9iplrial L NEI of O\n ner/ tosse Caritra.cl ar a A@erii or OwniEin
Namle. . _ .... .
Addresis:
s11A118.CIF RLORI
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Addresls:
City:
State:
City: State:
Zip: Phone
I e(z .SD C,(s
Zip: Phone:
(NamEi of pEuis acknaw lec ing J
REE SIN PLE 11ITLE HOLDER:
_ N of Applicable
BONDING COMPANY: _N of Alppliciat le
NaFTI El:
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lceiniiiilicationi ,V?k
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Adc renis:
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Ac c rEiss:
City:
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City:
Zip: PI -one:
!I.URERVI9CR
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OWNER) CC NIRACiORfARFIDVIT: Anni'licalTaniisHsrElt madatoattairiapermit ladotHEiwork arid iristallatianasiricicateic.
I Certify that nio wank au iris tallal iani has commeriaeu pnicm to the issL anicEl all a pEmenit.
!It. lc ciEi (launilyy make is ria nepuEiseriialiari that is 'grariting a pemmil, Ai I I acthonizEi 1hel�FF ermit hole Em to be ilc iF ei subjEici stnuctc 116wh icH is iri aaniflict witH ank api icat Is F ame.O�n rims Assacialiari re IE by la\n !i c I andlcovenariis that may restrict or ppiOhibit se ch
stun al urel. RlEiasEi corisu It witfl Nat r Hon i OwniEirs Assaciatiori anu rEMEiw ycw n dEieid fan ariy rEisi nial ianis Mich may apIP1IY•
Ini canisidEmai ion of tH a'guanii irig oll i h is nequ ested pEmmii, I c a hEoisbV a@InEiEI that l will, iri all rESPEIC1 s; pEuifanrn 11-e wank
iri accorc aricEi w ith tli Ei appinov ec pllans, l hEi Florida 9u ilc ing Cad es and 91. It cie Cau nitV Amenic rr1Einits.
THe fallow irig be ilc irig pEmmit appllicaiianis auEi eNempl ilrcrm unit er@lainill a fell cancuruEincy ue%iElw: room acditians,
accee9ar)l s1 nucte nes, w imminpl plaOls, lences, tialls, sigris, screen roams and aacessany uses to aniotHer nari-rEisicerilial use
WARNING TO OWNER: Your failure to Record a Ncrtice of Comimenceimient miay result lei you r paying twice fon
im prove rrients to your prorlEirty. Al N otiae of Comlmenaemlent mit st be neclarded and posted on the jobsite
bEifore tl' a first inspection. If yon intend to obtain financing, cionA It with IendEir or an attorney It Elfore
commenciing work or reiaordine VOL r Notice of CorrinriEiricerrient.
KUV..//LV14
9iplrial L NEI of O\n ner/ tosse Caritra.cl ar a A@erii or OwniEin
Si@Iniai u a1 Cortnaci an/License HOIc en
STAIT9 OR RLORID n _ n (
s11A118.CIF RLORI
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COUNTY OR 4it r {�eU.t/► '
COUNTYL OF lit
THEiior oini@linstr� crit sackriawlEicg dbEilarErme
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(NamEi of pEuis acknaw lec ing J
(9i8n c rEi of Notary a ic- 91ate of Flanida)
(ig c ne of Notary Rublic- 91a1El of Flaric a )
Fleseanally K now ni 'OR Prad ucEic IC Einitificationi
PER iallV Kriawn ji' OR Pnadc Ced Ic einil iilicatiori
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lceiniiiilicationi ,V?k
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TV pe of Ideritifiaatiori
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1 Ia EXpIAES: Dwjmber 14,20-111
Clommissiciri IN a. T,-03,,30, I"130 tNotryse el
9 E7 PIf IE,1: Decdmba l4, 2D18
Commissiarn Na. 0 Ff g ( g { rySenkel
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PLANS
VEICE111A11ICN `>9BIATURIILEI
MANGROVE
COUNTER_
REVI.EIW
REVIEW
REVIEW
REVIEW
REVIEW -
REVIEW
DATE
REICIEIIV ED
PATE
CC IVIRLETEID
KUV..//LV14
A111 AIF FILICAIBLE INFO ML cR BEI CON PLETED FOR AIPPLICATION TO EIIEI AICCEPTUD
DatEl: .PElrmii NL mter:
RECEIVED
8 ui°Idiingl Plermit A p p licaitic n APR 2 6 HIE
H lore n it g ori c Llelu a lop rrleiri t Sleirviceis -
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HluiJdincl crd Ceidel fiElgclteiion Diuisier _IT. Lucie Gci� n[y^ tll
2_-'00 Virgiri icl � v cr ue 1, Fort Flieirclel FIL 3145 82
Phcirk: 117721.46J-11'953 Fa): 117721462-11978 Ccmmercia) REISIiC Elntiz i X
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Properi y Tax ID #:
flitEI Plan NamEl:
Rrojeut NamEI:
So t acks Rrorli Back: Right Side:
Left Sic EI:
Lot Ncl.
Bloak No.
F1110"TIlLt'.1mumm" Ed S.
Haaitiarlal wonK to oa KleltormEla c rlaen i nis klellmit- aneaK ail mat apply:
_IV eah anicaI _ C as Tarlk _ Gas Ripirlg _ ShuttElrs _ Wirlc ows/ Doors
s
_ Sled I is _ Rlumbing _ Sprinklers _ Generatcir V Roof a ' �� Ritah
Total 9q. F1 cif Constnuai iorl: 9q. Ft. cif Fiiist Rloor:
�I
Cllasi ofl Constr cation: ; Utilities: SewElr _ 9EIrItia Builc ing HeiFlf t:
If,w alu a a1 canstru ction is 2966 on more, a REICC REI BID Notice of (lorrimencement is necl u ired.
NamE
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Zip Cllcic e: "t �G FaA:
Rhode No q 4 15U 049
StatEl: FL
EI -Mail:
Fill in feel simple) Titles Holc en on next'plage (A different
from the Ow nen IistElc above]
S -N/ ail
St.ai Er or County L,iaelrlsEl
If,w alu a a1 canstru ction is 2966 on more, a REICC REI BID Notice of (lorrimencement is necl u ired.