HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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to
Building Permit Application
cr�^c aPd 7eveiaprner r 5e^rtes
5ucoing Gro Cote Becu!anoP Division
2300 Iirgigic Ave.aue, Fort ?fierce FL 349&1 J
phone %721A52-1353 Fax:(7721852-1578 COrnmercia' Residential
PERMIT APPLICATION FOR.
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'�, oery Tax ID �. Block No.
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' _crate`'il_ Address II95
2t 11 C;y: "&i Ja �a 3eo� state
_ oce =ax: 32-1 777, 1425J
J4pp� TP Code 3G9
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Fill in tee simple Title Holder on next P a (
from the Owner listed above) $t3� or Court, License
quired.
If value of con5[iuGion is 2500 or more, a RECORDED Notice of Commencement is re
DESIGN ER,fENGIN EER: _ Not Applicabie ! MORTGAGE COMPANY_ _ Not Applicable
Name. Name: _
Address
Gty S*ate: Giv Stat
,�.P. Phone. _ Zip. _ phone.
FEE SIMPLE TITLE HOLDER: — Not Apollcabie BONDING COMPANY: _Not Apol:•cable
Name. Name. _
! A.ddress. Address.
Zip Phone Zip: Phone-
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S-. . JC' COJnry maKes n0 , h
pr 5�zc-ion a* S g.antrne a pe-MII -uthon -is Pe. 70 oud-m Me uD �T_U "re
wnrcr Is In conflict with any anolit2bie Horne Owns: s Assoaat on rules by.>V15 or anC Ovgr Ls tha m y ez 1 o Dro6"br, xn
5t a tu'e. Please consult with vour home Owners ASSOC2bon ane eviell you- deed 'ar a. v reSt-,Irc, L which mai' 200:1.
-frT consiue,a or of the graO:ing o: this requested oermit. I do he'aby agree .'ar ! will, is all resc-ca. o2 -or, the w'pfk
,n accordance l.th the adoroved niae; °1.01 o. 3uild!ng Ceces and St.: Je County '.rneedm2n[<.
The following building perma aPpllCatI,nS are exe not i,or➢ Undergoing 2 conc,rrencv-eviewroom addi`uons.
2ccessory 57_ctUres, swi:-+'mng 0oo's, fe-ces. walls; "EE'ssc ee^ roo- s and accessoti s z_ =no h_r .nor-resioeniia, use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
mpro Vemenl s zo your Property. A. Notice of Commencement mast be recorded and ousted on tile;obsce
before the first Inspeccncn. if ycc intend to obtain financing, ccnSJ,t wit:`! !erder or ar arorney before
comm, inch worK O" re CordJi VP:=_ NoTice of CCm Mercer i
S
slgna'urt of Owren L=_ss ;Age S`gna[use o` Coats cc icensa �olde-
STATE OF FLQSTATE OF PLS,I,Q� �,yy/
COUNTY OF ( A COUNTY O 7 i/nl U,
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Revised G?.i 3Y2014
"RONT Z0 IN; N;; '. SLPERVISCR PLANS S_A TO RTLc MANGROVE
COUNTER REVIEVd REVIEW RFVIEW : REVIEW REVIEW REVi=W
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INiTIAIS
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