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Building Permit Application
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 2atel permit Numne' Building Permit Application _- -_and Deve!oomem 3e-:c_ 3w:o�ng ana Code Reaulcbon✓irsron 2300✓irginro Avenue,Fors Pierce FL 3498Z Phone:(772)=52-1553 Fax.(7721^-52-1578 Commercial Residential -_ PERMIT APPLICATION FOR. (�^ � � t� Address:1 O C1� / NV \ 1'75Y� 'ICI-P YCP -4- Legal Description: \ - _ IProperty Tax ID I 2 - (Rog _ l I _ _ Lot No._?9 Site Plan Name. \�� �� p r� Block No. rP,ea Name. M �'Y N W y f� CAA ll Setbacks =rent Back: Right Side. Left Side. - n10AAdiNtionalwomtoiaeperhOrmed un er rs err -check all that apply. Mechanical _Gas Tark Gas Piping Shutters _._ ��.ocws/C-o s _Frect.i[ _Plumbi`ig _Sprinklers _Generai0r Roo, ctai so o Construction: Sa -t.of-1r .`loot Cos or Cons-uction S ' -_l J V Utilities Sewer ,Septic Building Height. Name' Acaress. Conpany. n r r..•.�.r s "o ��d, b. �c<:;a��. 'SStale r Address: 008 Dr 7,C coca- rex: x/UI1-1 City 3e>cn State'.=! 'none No.� -�A0 U - Is 7_1p Code. 3 g.3-7 -a,,: I--,72- uZ3d E-Mall { }. (, { phone No TiZ 337-Ut17^ Fill in fee simple Title Molder on nett page(if different E-,nail. from the Owner listed abovel Stare or Count%Lic=ase. (? if value of construction is 2500 or more,a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: _Notapplica bie MOft?GAGE COMPANY. _No- App Rabe %ame- Name: ±;dbress I Address._ e,r State City. Stave- mp Phone: ZIp Phone PEE SIMPLE TITLE HOLDER: _ Not plihcable BONDING COMPANY: _Not Apollcable Name. Name. 4dtlres- Adores, cil ,. drone. Zip Phone .,_ lth L ,c rS'a a-o 'IsCo.me [ oor tq tire Is, b a'e t 1 11 c u ''��makes a pr s r on that.,e a t ng perm will authorize Pa '�2,older ou Id e s o c [.ugure wh s r onfl Icawith any apple[ nl i1 me �n s Association les.by. +s or arc o 2 ,t5 thatmay-e p Jh.b1-RJCf Q Please zonsuh with your M1ome O /ners Assoc i ton anC e w your deed o'it 25tr R 1 which'a''no" n:�J"'S:pe ci:pr`0 the granting Of tn15 ragvi teC cern.IL i do hereby agree t'^ar'will,In all reSP?Gs ne^orm t_he wort .occ.rdance w£r-he aoaoved plans.to gor,da Bmldjng CoCe$-,o St l!ce County Cmecdi'll '..e foibwieg omldme oe-rl aP"Peo-tens are exempt from uneargoing a lull mecl,mency-eNew mom aec,ors. -lesson 9,nj¢ur_s,swimming occe feces,wells,signs.screen moms and accessory usesr another non-residenral use WARNING TO OWNER:Your failure to Record a Notice of Commencement may rill in your paying twice for improvements to your property.a.Notice of Commencement most be recorded and posted on the lobsi*e before the first m5pe¢Icr. If yec intend-o obtain financing,censu8 with lender or ac attorney before •Tr^ cin worK or recor �n YCUr Notice Ci_Cmmen Ceme, t ` 1 `L a Age.Y 5-§ :ure O a s scan eolpe STATE OF F IDA STATE COUNTY OF COUNTY [ e`ergo�g Instn mt was ackcowleaee :o -+e Tha orge•ng•� - - - wlsa5 so-e _ -Il4r- —- - 3.� b-: gh,, 2O: s eoa 1 b, Na on cn. ml, T Jf erica' aucea la . u_au Jn" I . .n- c ,Y BPOOKESDGETI C1,- smr No !�'"••' .p'==FY _____ ' EXPIRE ti iuna25 0 9 �--- vrtEIIRirAsl�n7ernU::s -' ells °RONT ZONING SUPERVISOR PLAN5 VEGETATION SEA-UR-LE MANGROVE COUNTPB REVIEW' REVIEW REVIEW REVIEW REVIEW REVIEW N N N N N al N N N N N N oW C 6f W W W W P W W W W di W W b W w W O! P V 0 N V V V V V V V } N 1p O a Ol V W W N f0 W'I W W N V G �O©m � an ss _ z m z �pFo 3 m 3 z®m a ti m aim rn 3 r^mn y w p N F m = o w X N 4j Z g n Z z a •T.,0'9 5011 w r a m W p 4 a m m�0 H 33 om; a e 7� o� 7 3i0 N'm I H QQ� � sz o n 00 mg�m IC = N O J 00 � C a o u d N Ski n om°Qo W'a S A p A 1 0.n N W 3 W G m Q 8j A 3 w'r v a No P N N a P o P o a q e o s .iSU�1 a P P a 7S o q q e a c m m a c Z.Z Z Z Z Z Z z z z Z Z Z Z Z z x \ �\ f loo e:, % ! . a !=2 § ƒƒ Ll °er 5 }S �| - � - / \ Z ] (} \ z � ; � \} : \ [ EF � > % &