HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Pern!t Nlumber:
Date:
� T
- w
%'aeninc and ')eve! omem 5e^,Ce5
3uiiding and Code Recuic`<ien Division
1300 Virginia Avenue, Poe Pierce Fi 34981
Phone :1772j�t52-1553 Faxi(772)452-578
PERMIT APPLICATION FOR:
Address
Legal Description:
Prooerry Tax ID #: �}—
Site Plan Name:
Building Permit Application
Commercial Residential
Project Name: _.
Ri r; Side: eit Side:
Setbacks =rant Sack �''
_ nt
J'Dor
drtiona wo t0 _ pe Orme under this perrna — u 111^ a:: -' -
Piping Shutters
Cas
Mechanical _Gas Tank _ P' .g —
Plumhi Sp rin liters — CJeneraioi
_ F_iectric
`otai SG. I o: -0, SULIC'L'Or: _
/�( 71 (/ ! itiiities: _ Sewer _ Sep,ic
Cos of Construdicn: 5 _tel—
Adaress. L
R
Zip Code:
S?ate-q
Phone No.
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
hL
Loi No —
Block No.
✓windows,/Doors
Roo;
Building tieight
Name. Ii-�^� !I a . Company: ' .�, sm .7= IX�,rns� � D&
nr
Address: 108
City: l.:d.ian i�a�ij%w Ue>ch State:=i
lip Code:�3%G3_ =ax: 3ZI- 777- z�Z344
Phone Ne. 772 337-=,<q70
M
E -Mail
Stair or Court: License: j(
mmencement is rea,uired.
if value of wristrvctiort is 2500 or more, a RECORDED Natice of Co
n
DESIGNER/ENGINEER: _Not Applicabie ! MORTGAGE COMPANY: _ Not Applicable
Name: !. Name:
Address i Address
Gtv: State: City: St='
Zip: Phone: Zip: Phone'.
FEE SIMPLE TITLE HOLDER: —Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address.
❑iV: City:
zip Phone: Zip- phone,
e-fy tha: no work or bristailavon has commences Prior to the issuance or a per ma.
Se .IC'2 CourtV !!la Kes '0 rePrese'1 ciion that s an^Ing a r -mil will c hori-e ih pe m : Voider u bui1C re suo 'eC t. t_r"' re
st7jczure, PI asE Consult withPvour biome Owners Association andiOn s evi_wylaws or you, deed or anv ress c'nOns wit ch T v aDP�h 71. _ter'
in consideration of the gr_-nting ofhis.eqoested.Permit, I do hereby ag e i^at ! will, I! resp Qe! orm the work
in accordance with .he aooroved Plans, t. _ Flonda Building Codes and St Lurie County mencm n-'s.
-he following building Permit aGPllca to s are ex apt from undergoing z `u 11 cone' r nce review: room ads_. chs,
accessory structures, sw,mming Pool-, fen—'es: walls: signs, screen rooms and accesso-y uses to Bnoher no • esldencia, use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may, esult in your paying twice for
improvements to your propel zy. A Notice of Commencement must be recorde'c and posted on the iobsite
before the first inspection. if you intend to obtain financing, consult with lender or an at before
cemmenci worK or record+ , r Notice of Commencement-
s
_ Signature of Owneri Lesse=_,44gen- s�gn�ure c: G a c , se ao
I STATE OF FLQ��Q�r STATE OF FL
COUNTY OF
{" .1 \-�IQ%Z� COUNTY OF
1'e - r�0i�1P. r . J �i W -'O C'c"'
Tne 'orgoing Ir - - ':as acenowled e : �efo-F -*F
tni5 Cf
'i
,
lig, lkor acrd-',
ers C.
J
na no roduced,den*i`ca-on 'r o a -K nProduceo dencificauon
om SeBROOKES➢BETI 0 1.. r. do BRIh$ �Eil �
I MYCOMMISSIUJnFF244655 I I MvrOMMI° ^' FF24465 I,
Revised 0 15/20 i - �.:.�•. .� -_ry . t a z� «� a
R_V!PWS FRONT ZONING SLPERVISCR I PLANS VE-GEiATlOti SLC, TURT!_= - !v.^NGROVE
COUNT�R REVIEW REVIEW REVIEW REVIEW REVIEW RcViEW
DATE
COMPLE'. E_.
IyITIALc
§.
§(
|!
"IME
7 B�|
§
(
^
»
7
}|®7
\ *
¥
\
!q
�R
�§
K
�
■
in
2))§
R iF
;§
!
Fr
z■|