HomeMy WebLinkAboutBuilding Permit •
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
?_F Perm t N:.;moer:
_,-.-
: Building Permit Application
i :1!Gni71.nc e'd Cevelopmer:Services
1 3w/ding and Code Peauiarion Division
I 230C Virgihic Avenue, For:pierce=L 3498.2
I Phone: r.772)462-1553 Fax: (772) 452-1578C ommercia) Residential ✓i
PERMIT APPLICATION FOR:
tel ! .._J_l vL-1 gBC.p
_ego Description: ` 'twos r-A - 4-knk. re9ef Y€ tVT Si Ca. 5u9 V-tron..)______
Iv a1 _ �^/ 5 F / y 7,—I Lot N o.
��
-.pe Tax to g. r]fiLeh 1-�.� (
cry
Block No.
Site �ra� Name:
Prc•eCt Name. I
Setbacks trent _ Back. r2igr�t Side
Left Side:
graing
ifma
Ii I f-,..;1-6,1. 1,Ice cni' iik.k- -,,<1�� ;fix Zx7 1 `�br l�_ r
I� •
,dtttona wo to a pe rme under t is perm rt-c e
c a tat app Y:
it __ _ —Me:h'n„a' Gas Tark Gas Piping _
sI',ut:ter5
✓LNindCws/Goo's
?j:�;-,!-_i^E jprinkie r5 Generator - Roo t
-
!
!I C;2! Sq. =T- Of Construction: C C� prri =ioor:
_ i
!; "ist of Construction: s 2'2 n- CO Utilities: Sewer _Septic Building Height:
t
Name• 8 o' .nn,ci, L & .
rCC:i
`I QL12 'i e � E
�OMPanv. :r..r, Pfif;sc .x 6‹("4 z :Del ,,,..-•act' "..
I 4 I_ sate:-�� Address: i l05 a!`ial+artiil( Di -
•
� i 1' /7
II71� i A : city: Indian Kaffir''— ge State: I
; ;_ 'ode. Pax:
ii - . .••
No rib-Igdn._0 I Zip Code. 3293 ' =ax: .32.!- 777- 4723,4
II . ;-Mali ta I.IA Phone No. 7/ 33?-4q7)
•
Fill in fee simple Title Holder on next page (if different . E.-Ma li• ,,L:c'�SS;nc:uncia.°` '.,'^'•:7= =-J^
from the Owner listed above) Side or our y License ..."-7&,),..'"1-3 -------j�
! if value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
I
Name
Address
c -v
'ib Phone.
Icabie MORTGAGE COMPANY: _ Not Applicable
Name:
PEE SIMPLE TITLE HOLDER: _ Not Apalicabie
Name
Address
Phone.
Address:
Cirv: S -at=:
ZiD'. P6cne
BONDING COMPANY:
Name _
Address.
G2y
Zip. Phcn=.
_�h, tea[ na �rcrk Or nstailavon has cor-menc20 prior to the !sscan_e Of a oerm;t.
Not Apolicabie
>i _ucie bourn, mares nb r?pfeS :ciion hat is oreniing e Yerm'; will au'ho( 2 th. P2 m . ^bider v bU M the SUDIeCt �Z-UGur-
wncr IS In conf=lict with any armliccbl_ Home Owner5 Assxlatlon rules. by'2ws or Ohio cod tots th2, may iesirlG or proe'b;; secr
$t'u' , e. Olease consult with vour Home Owners eisscclatior and review your deed Por and fest-ichcns which m2V 2on',
n cons,ce2ttor of the granting Of this regaested permit, i do hereby agree L-ar !will ie all reso-5 hie:?orn %he word
accordance w,Zi, -he aoareved dib^5, tire Florca Building COCes and St. e Coonry m2pdment-s.
-he following ouiiding PermT appllca-iens are ,e ,,t Prem undergoing a 4Ui" :orcw r.ency review. room adcitions.
ECC2SSOryAr:,C u, es, swrrnrning Poo,<, fences, wails: signs. screen roo:-rs one a,cessore - s =noth -ro:^-r=5: dentlai use
WARNING TO OWNER: Your faidure to Record a Notice of Commencement may result in your paying twice 4o'
r:rnprover^enLS -to your property. R Ncr icE of CCommencement mast be recd -de and Oos'ed on the jobs;xe
before the first inspectic. . if yon intend `o obtain financing, consu:t with erder or an at,o:,ney before
,nnrm<r-ncM2 worK or recording voir Notice of CcmT -ceme fit, _ A-
S;gna,.ire o%OwrenLessee=_/Age -
�s,:�;..: ,....�. _. a....,.. _......�....,... _.
l STATE OF FLO1 �r
STATE OF FLOR
COUNTY OF
COUNTY OF,�A/C11.�1N
fne 'p rgc n� in grUr.=n- 3s ack-:oma:;ec
• NobW-PUNIo.St"a rA F1111J
�'
(�me of person acknow;ecg-ng
4a>,e of oersen ack ncr+ledcine 1
Ashley M Antonelli
_Sian .ere o� Notary bL�- Sta,e r Flonda i
! igcature .:� vo- r p r. a.._ o" Fferlda
?=;tsr';jG ij;�V_� y;p My Commission GG 1529)0
eaarai!v gown CR 'rco uced to r ificanor:
Persorally Krci OR Frococec icentificahen
_
-. re O` de -::£Caton produC=_c
Vpe Of loeotlfflcarion -'educed
�.. 6Ypn VO lDGl
co'-nh'csror. W. lscedi
I�EaR
• NobW-PUNIo.St"a rA F1111J
�'
�4 Nnran. D�.nr;
1s M Florae
Ashley M Antonelli
Ashley M An
netp
?=;tsr';jG ij;�V_� y;p My Commission GG 1529)0
My Commis
GG 1529)0
'4and Expires to/1812021
thin
no Expires 10118
21
?=`. 'l':'S =RON? ON:NG
SGPE'VISOR PLANS
VEGE'A- IJN '; SE ;• -'JRT! E
HANG ROVE
COUNTER REV[, -\A
REVIEW REVIEW
REVIEbt- REVIEW
RFVi�W
N,_L4l c