HomeMy WebLinkAboutbuilding permit ALL AP PLICABLE iNFo MU-St 6;1; COMPLETE FOR APPLICATICN TO BE ACCEPTED
Date- O .2.18
P'errnit Nvrnber:
Building Permit Application
Fd&F n.0 Old'DV VOOPM Lai?t 5&fVke5
Pdtrig arld Code Re$ueoba r j�YLf!gio 7
2�00 Wpoid Avenue, rewr Prerce FL 34982
Phoni�:�772)462-15S3 Fax;17721 462-1578 Co rnrrrer'Cio r Re5iderltia I .
PE RIh IT APPLI CATI U N F 0 R: To Select tram dropbox. CliCk elrrOW at the Ed of line
PROP ED IM P RDVEM E�l�`LOCATICI N,
Legal Description; Dum walk t thO OWan aka Sand Dollar Nor DIi�� B, Unit 715 ,(or 41
Property Tax 1D#= 35� - 7- 95-1]1 07
51#e PIarM Name: Lot NO.
Prvjert Nanie;.
hit d - Electric Tank[@ss W ter Heater Block No.
Setbacks Fri3nt_ Baer: Right Side Left side-
DETAIi_ED DE SCR fPTION 0FWORK.
Electric lor Water Heater
OQNSiRUCT710N INFOFkMATJON:
trl�irr #rrn a urti t r kliis r}� i T
a a
Plc w
LIIfV.AC Gas Tank Gas Pipl =
vt#ers Windows#[}ors
Jam'Ele gy Hum binR HSprinkfers QiltneraWr IR00 f Roof per,
fob Sq. Ft of iCor►tiuction: 5 , F#-of First Floor,
Cost of Clans#ruefti -$_ krt lines:0 Sewer[]
peptic P ui Id ing Pi eight:_
OWNERILESSEE; Mh1TF ►CrOfR:
Nay
NameAIdr €, r curt r7 pi I UC e, r►c.
Dr� �wn panw; I
City_ eat State-Cade: Fax; Address-
Zip
oros. I V
V to — I
x,, ,, gterl I
Phone No, Mate,.
EWaII
0j ISr I s _Corn Zi corer Fa�71.2 u
Phone Nap,
Fill iln fee sirnPleTrtle Holder on next p.Ve{ifdifferent E-Mail; Irrtrep InCrC _gmaI m
FrOm the Owner Ilsted ab .e]
'+ State or Ci3unty ticense
id wdblue+of c, ftistruAction is S2Sau or rr�We-,a FLECOROED Notice of Commr_nce ni,,r ,w requk.d, i
SUPPLEMENTAL CONSTRUCTION LIEN LAW IN FORMATION-
DESIGN I RIIENG I NEER- Not Applica b le MORTGAGE t_OM PIANY: Not Applicab e
Name: 1 Name —
Addrew Ad d ress: A
Ci . State: City:
Zip: Ph:ona Zips Phone-
FE E SJ M PLE TITLE FIDLDE R: _Not Apphca ble BONDING C€ 1PANYt Not Applir,' e
Na me: Harne:
Address: +address.
city- City!
ZIP: Phone: Zip:(YW RFl�ne.
N ER 1 CONT'RAIC rOR AFEPDVIT;ApOica6on is hereby made to obtain a perrnit to do the w*rk and Installation as indicated.
1 certlfy tlae no work or i11S a Ilation has commenced pricir to the issuance ref a permIL
St. L ie Eaur7r�rr�#rs nv repr'eSmation tha 1s granting a ppeyrrMt will aatthprfie tie mit h er to build the subject structure)which is in C�flict With aN applicaW*Home�s Assaclatlori fultn bylaws af a M uenank 9 Wilt,may restrict or pr�4bFt such
structure. Picase consult with your fame *leers�4ssaciMion and review r deed rir any restrictioqi4 which may apply.
In consideration of the granting of this re+qumed permit. I do hereby agrm that I will, in all re•specM peffo{m the work
in aci;vrdance with the approved plmns,the iflorida Bulldmg codes and St-LWie County Amendments.
The fo4lowing W ng permit applicauiorks are Oxempt frprn undergoing a full ccmcurrencyr review! lawn additions,
acceswry structufes,swimming,pools.,fences,walls,signs,scr n roams arld OcTessoryf use$to another acin,re 3dentllal vu
WARNING TO OWNER; Your failure to Ilecod a Noetiee Of[Or Milknoernent may result In your
Irri rovemerits to your pFropert3r, A Notice of Co.rnrriertrement rinust be re--corded and posted onng Ijohsite
before the first inspection. If you intend to obtain finaneing, consult with lender air�in ettlariney before
co m rr in work or E or lien ou r Notice Of Commencement_
a Uri,, Owner,.1%seer�Canvactvr a ent tv Owner Sig lore n'Cantfiar�':ror rLic rnse Hceid
.STATE OF FLORIDA STATE OF FLORI
COUNTY OF GIOLINTY' OF- � CAI
The= InTrAnt A, sac Ior me TI►e r g instrua mr was a.: )"lode eforc me
this of
by thi5 _zPaY43F . 2 by
e-QF p makingstatemtnt P48M perso a ingstatement
Personally Knc win OR Pradvoed identification Re.rKnnally Krowm OR Pnod rced Ide;ritiflCi tion
Type of IderSrflC3tl gyps of dderlt. atl
Produced Produced
r�
[Sign t
ary Pkabllc-State*FFlorida j {si t Mary F"vd�lir-State of Flcrida��
f �Seall
s L.ame�Ylisswpn N rru`ft
*Mm mews RFVFE FRONT
a41 A N VIEGE rATIO N 5EA TU RTLE MAN!G ROV4
I COUNTER REVIE` R.EVrEW REVPEW REVIFVV
FLeOMM
O�4TE
RECEIVED
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THIS RTIFICATE ISSN A3 A MATTER OF INPOTFkMATION ONLY AND C FER3 NO RIGHTS UPON THE CEFt71F.IGATE HOLSTER. THIS
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RIrPRE3ENTATTwS OR RRODUCM.AMP THE CERTIFICATE HOLDER.
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