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HomeMy WebLinkAboutbuilding permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Dale: Perm- Nurnber Building Permit Application bnnmo and Deveioomen:5e:'ices 5uiiding and Code Reauiation Division 2300 Virginia Avenue, For Pierce FL 3498= Phone: ,772j ^52-15S3 Fax: (772) 451-1878 Corrimercia' Residential PERMIT APPLICATION FOR: address:%C5 /nC; _ -- Legal Description: hAY�V _ ( Mao-13 l 02fwR 1 `L - i l ?rope ObY1- 000 ry Tax ID�: l �7l)' - 4.�U -L - Lot No. CNl Site Plan Name:I %_eci _1�_ ` _X j_A1WA1 Block No. Project Name. Setbacks Front Back: Right Side. Left Side: J60-- Additional work o be performed under this permit-check all that apply: _Mechanical _ Gas Tank _ Gas Piping `Shutters ✓ windows/Doors _Electric _ Plumbing Sprinklers _ Gene2tor _ R.oef 'otal Sq. Ft o'Construction: SG. =i of Firs: =1oor: Cost of Construction: 5 _20—e,;o . Utilities: , Sewer _ Septic Building Height Name Ndme'. Address-fiffm _�' ,' Company: r r, cv(�;d ,.i�� .� . city: ( Raze:'-5.. Address: 1108 Zip code:_ q _�_ F1ax-: n Gry: ��dian tla���.,: 3ed�n State:=� Phone No 1' M2 tP�2 1 Zip Code 3L93 =ax: 32-1- 777- ' 3`I E-Mail: Phone No. '72 337-4(zr 70 Frill in fee simple Title Holder on next page ( if different Nail ESs�cw��"sal _o from the Owner listed above) Stale or County license- ( } If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: _ Not Applicabie MORTGAGE COMPANY _ Not App!icaole Name: Name: Address: i Address: City: S te: ,I City: Zip: Phone: Zip: -- Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicabie BONDING COMPANY: _Not Appl!cable Name: Name: Address: Address i Ciiv: Ciiy: Zip: Phone: Zip Phone: ;certdy tha-,no work or snstallat,cn Gas commenced prior ro the Issuance of a permit_ Si '_u C'e County' Flakes no"eprese"1'c.ion -hIT :5 granting a rem -- will uthon-,c ine r2'm oiler?o 0 I he si 1 -u. ,re whicc is ri conflict with any aoplicab!e Hone Owners Associat or rules. `yl_av s or a1C cov r _ss t that may ec-riL�or oroi,ci-such structure. Please consult with your Home Owner_AssoGoiion and :evlew you ,:_ed for any est'ictlors which may aiso p. in consideration. of the granting o=this rzq Jested pern'+ i do he- by agree that i wiil, Ir, all sesoec%s, oerform the work in accordance with the approved dians,zhe 8orda Building Cotes and St. Lucia COun-V Arroe:I_mess. ,,',a following building permit ap'vllcavons are exempt from undereoing a `oli cona.'rrency-eview: room additions. accessory sruc ureS, sw,in mi ng pools.fences. Ada l ls, scans, screen rooms and accessory cse5 L: =mother nor-residenria. WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for improvements to your property.F, Notice of Commencement most be reco-del and posted on the jobsite before the first inspection. !f you intend to obtain financing, consult with lerder or an si-orn=v before commwrcing work or I-Acqrding your Notice of Commencemen- AM IN A#Wtx .01 Signature of Owner/Lessee;Agent ! Slgnarir e c`Con-ra¢or;'_kense -olde- STATE OF FLO A STATE OF FLOR�A� ) COUNTY OF (� COUNTY OF j �{'Un VC� ne' ( C rig Inst^he'll:was ack :J 'i eogeo 2 O-e ^t2 � �Y'2 fur&OIp2-nct-umer � ao acY.nO leagec hero,e^e this day of ry rc�� �:^ b; Thin. da. r �Q' 2_o LS. 1 7 I,Na or Ar n g) (Na ors - ;n iec Cg i i I u t - :e pf Florida ! Ig. at r - i; S -_ of rlenoa �rGduced Ide"Iti`i,aU,or_ es :r a: 4 Frocuc_d iser-ihcavon Y. e f td trfr -';an ro - c ro - used n Ni00NESZtGEA or'., KE5ZIGEFI MYCAM'A7ISS^vN#FF244655 w_ My00WJ5510N#FF2440 0=p4`^ BordedThmNotary Pubic Uiidewters BonUetl Th m Notary Public denriters Rol.-lsed0?:'7d;2C's4 REVIEWS FRONT ZONING SUPERVISCR PLANS VFGC -.ION SEA-LJR'.LE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVI EVv REVIEW DATE COMPLETE I.NIiIALS --- --. | ® ° 2 - � s ci � C; � { - |; , � . � , � � . , , , � . - j § | � ® ' I | | §\r§ ! § � - � o !! !] | k)|! " ■ ; § k � B � e ■ q ; ] | c m f © k c � & r |` ■ d ;8 �� �* � � ` ®& ` o ! t 9B _� _ .� !® •! ° | | ! »7, ; !■ :| �. �■ | ® )• �$ k kk \ \ omU9FL \ - ■ : ! B © B § 8 ) ■ : ! \ ; g ■ § � | k ( ) ! | 0 ® f )§ k R § § , 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 w m m m o m 0 o a N N N H N J ^ 8 m e g o N > p N H Z m C F m I} O i} m P g s 's, 3 4 e