HomeMy WebLinkAboutBuilding Permit Application 1 ' I
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Al!APPLIC.A8LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
- V9 Pernnit NLJrnber: L9,05-0011
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., . Building Permit Application
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5w/ding and Code f?eguiation Division
I1 2300 Virginia Avenue, Or Pierre:::.I...34982 ..
I ?hone: i,772)452-1553 Fax: (7721452-1578 Commercial Residential . ../
III: PERMIT APPLICATION FOR:
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!1 -,deress 01 Dal , E.ch L) pi r\ c \Y ft)(* VterCS -C-1 • C
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1 -.•.csa: Descrption: U. b a' 0 _ ba , ,.. _ 11) ill, .4.11 • -.M.- b . I Ala . • . . . _
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1 Drooer7y Tax ID : 1,,Sk 2- -81\i :_- h ) 05 -(0)- 5 LOt No. LOD
Btock No.
l'i SiZe. !ar'r Nar,-i :
1 Prc.,:ect Name. _
S-,..zbacks F;ront Back: Rigrit Side: Left Side:
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II cditiona wo to .e pe .rme un.er is permrt-c ec a t at appy:
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.i _241er:hec:a! _ Gas Tank — Gas Piping rzeShurs
• Z Windows/Doors
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FiectrIc , . Sprinklers _Generator Roof ,1
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k CIa Sq .=P 07'C.:07?Ftruction: Sof.
O. Ft First oor.
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il •1 .Cost or Construction: s eSS 0 -( fl) Utilities: Sewer Septic Building Height:
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-1. -z--v-1.0,v Name ': y..)..anno. Li-
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,11 AC. r.SS.r-Anq E ?ilifklb A 0 Company: Mfr. Elf-,1:eapr i se ..7;. Fxcvcc,4 c;.P4 ,...=....•ale =','
II. enL-kR.:e.yr Q qtat -c 1 ! Address: i fO5 7-0?),.abctu.,31( "D/- .
I. 7ir.-: Code. ci \ Pax: M L V ; city: The.i., )4...- x...- Ge...c2+-‘. State: ?•-:! .
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II e NC) 5Sg7Le,OLr-3 Zip Code. 32:937 Ix; 32i- 777- 4t3 4 I '
1N-J..1 IA - PMone No. 772 337-44770
Fill in fee simple Title Holder On next page ( if different E..-maii. ::,::..v,.- s51-.,4::.:,nt"ieki, v•z•-•,.,_-; ,....),--:
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1 from the Owner listed aboveri • State or Court f License: ---,4L- 71 7 .
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1 If value of construction is 2.500 or more,a RECORDED Notice of Commencement is required.
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�n Consiue2 iCr pf We granting o' -his re9Ces'ec cer, T;r, i do ",eby agree t:^gar w, II, in. all reso=C.-. oe-Form :he work
c accordant= ,vith -he anoreved ,,laps. e 9o1 a Building Cec e5 -,' Sr. L_., e County ,ne _-rnen'5.
the folipw'ln� Ouilding pefm'i aGPiicaiiors are exernrit !rom uaCergoine In fait con C'u'rency review. Foo Tt adcl ons.
c CCe$SO.ry S<rJC.'Aes, Slvi:-riling coo!S, fenCC5, ♦vells, signS. scree^ roo:-S and accessc' --SaS F 2.10th .nod-resiaeniiai cse
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
rnprove''^ent<_ to your property. A Notice of commencement mast be reco-ded and pest=_d e1 the;obsite
before the first inspec[icn. If yet intmend tc obtain financing, tensa;t with ierder or an attorney before
rnmma+nrirm work nr rrornrrlinc Your Notice of CemmeCceme*., n
Slgnztdre P'C. re,, Lessee/A.-e
STATE OF FLif�� STATE OF FLORIDA
COUNTY OF 'C &OA COUNTY OF 911—\(C�tA
fie `crec. vg -n <,v : n-y� s ck ov:iec§ n� in_ lecEer{� r'o-c e
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Clo, cp , S g atcrE ^( 2t' P'- l -e o scr da
"iced l0 de,-,f!ca- or Per orally Krow L Froe Jc d identifica, en.
ype o. Ideril .aeon ? Cduc_d_ _
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No dry Public State of Flo,
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DESIGNER/ENGINEER _
Not Applicable ! MORTGAGE COMPANY: _ Not Applicable
Name.-.
Name. _
Address
I Address: _
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?io Phone _
ZID. Ph�n2:
FEE SIMPLE TITLE HOLDER: —
Not Applicable BONDING COMPANY: —Not Applicable
Name.
Name'. _
AdC'e55.
_ _ Address. _
N; N,-- SLPERVISCR ?LANs
CiiV
p Phone
Zip phone
:ha. CL wCfk C. nsiaNation 'r ascoTTen.ec Prior to the siLa:i1 e of a
-. LUC:c Cour T-0 mdKes r0 repra5tn- ilOn
hax R o-entine a Pe -m". dl eo'hor .a Ta �:2-1"::^.JId Er L bdllh -h2 ID t •UUIC"urc
;;nic ` s conflict with any applicable Home Gwner5 Association rules. by'-ws or anc Cov2r'o"i5 that may or oro'"OL vJ_r
tenni.-
�n Consiue2 iCr pf We granting o' -his re9Ces'ec cer, T;r, i do ",eby agree t:^gar w, II, in. all reso=C.-. oe-Form :he work
c accordant= ,vith -he anoreved ,,laps. e 9o1 a Building Cec e5 -,' Sr. L_., e County ,ne _-rnen'5.
the folipw'ln� Ouilding pefm'i aGPiicaiiors are exernrit !rom uaCergoine In fait con C'u'rency review. Foo Tt adcl ons.
c CCe$SO.ry S<rJC.'Aes, Slvi:-riling coo!S, fenCC5, ♦vells, signS. scree^ roo:-S and accessc' --SaS F 2.10th .nod-resiaeniiai cse
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
rnprove''^ent<_ to your property. A Notice of commencement mast be reco-ded and pest=_d e1 the;obsite
before the first inspec[icn. If yet intmend tc obtain financing, tensa;t with ierder or an attorney before
rnmma+nrirm work nr rrornrrlinc Your Notice of CemmeCceme*., n
Slgnztdre P'C. re,, Lessee/A.-e
STATE OF FLif�� STATE OF FLORIDA
COUNTY OF 'C &OA COUNTY OF 911—\(C�tA
fie `crec. vg -n <,v : n-y� s ck ov:iec§ n� in_ lecEer{� r'o-c e
--Il-
y`^Qaa
E (L}' of
Clo, cp , S g atcrE ^( 2t' P'- l -e o scr da
"iced l0 de,-,f!ca- or Per orally Krow L Froe Jc d identifica, en.
ype o. Ideril .aeon ? Cduc_d_ _
Co,".nlsslor. N4_a isealj
Ni; !LI c
�..
?y �� GG T, d
s
r
No dry Public State of Flo,
ih - mi nnel"
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Expires to/18/2021
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VANGROV_
COUNTER
REVI_vv REVIEW REVIEW
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