HomeMy WebLinkAboutBuilding Permit ApplicationAli APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO 9"CCEPTED
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Building Permit Application
Commercial Residential
PzlRM! T APPLICATION FOR:
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Name
Setbacks :Front Sack. Righ Sde:
--ft Side
0
Loi NO.
Block No.
AdCrional wc; R to be per-ermed unties rnis pe'11�11 — «.. _..
Gas Pioine Shuaers ./Wlndcws/Doors
R�
�.. :. '7< _ Cennkiers _ uc'':cr�ivr _ ..�C
�O `I- Oi FirS� � iGOC
e l( (A)Se rc Buiiaing Height:
C s r'u. or. 1' UrJ res: _Sewer _ P
Na G'c 1
deress.
L
a code:
-i:one No.
Fili in fee simple Title Holder on next page { if different
9 Orn the Owner listed above)
Name: _ :J[ LU11i H Uk
.j - � flrcG RN
Cornpany:
address: 1105'o^-anawd Di
Cty:
7_ip Code '793 7Fzx: 'Li 777- �'Z3U
Phone N 772 337-4470
Mad
nunP- LIC2n5e-. n�✓j
I; value of construe lon is 2500 or more, a RECORDED Notice of Commencement is required.
Nzme: _
Address
y'.
FEE SIMPLE TITLE HOLDER:
Name:
dares
_Nct AUoMc Lle MORTGAGE COMPANY:
-- Name-
Acdress:
71p. Phone:
Not .Apo!icab!e
BONDING COMPANY
Name
Address
civ
7:1. ?hone'.
Not Applicable
Not Applicable
"na" -. .-ti ..� . >.c leu •. g ..T2n:2 p 'O o ,h 's 'Tee Je ' .. i.
or na s e perm' Mill autY'o e -� pe."^I - order o o,nid _he 5uoleC M-YC7ur2
_
ae 7 2 . o. c �wnc >5xtzno izs Cy ors o ed Co any _ss:rno sthet 2vh Est mCy r000h:br. cu Ch
.. :,_ Se _. .=-uk w _ 'C,.r =c. _ wn_rs > nC-t;cn c en : vc
s1' rip ye rn the `Pork
e. o cue
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-o,es C S'. _ cn.V m rte•^ $
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Iconare_..e:-+o eo'.^.d raoing<I orc .enca evew, oom ddilons. ...
3C 2S Cr Sr'�C� S >wi" ... 2 �`"-C— e_,e_. w'a'ils_ 59ns. s< ee rooms and ac ssory �Sc> . another no.. ?S de'LLiai Use
in
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WARNING TO OWNER: Your failure to
Record a Notice of en -n Commence �e t mareccydrQsultnd posted oFn� hel�obste
n\e-'.en s o your : o�.a �Y - u I, w:t ender or an attorney before
'Tr r -�'o i^. rip r tng,
be f � s ':SD-.—io❑ t y0� t ; r-
p'_1'_,: C..'1e'-
_C .E - 1 work o" r xi
STATE OF FLOfjjQA
COUNTY OF InrCi
BRQi 62f M -_ —
MY COMMISSIQN # FF 244M
EXPIRES: June 25 2019
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STATE OF FLOA_
COUNTY OF
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