HomeMy WebLinkAboutBuilding Permit application--7jtjjqe q_'�O
Ai APPLICABLE INFO MUST BE COMPLETED FOR AApLiCAT10N TO BE ACCEPTED
Per --'t M-inber.
arc, 'EV?i0f7rnet7:.;2"-'�C�S
Lil(IiRCJ and Co6e Recu!ation pivisio•n
230C ✓irgi:nie Avenue, For-• P%erce =C 34981
:>ho,ne: -I ) S2-1SS3 Pax: (7721 ^-52-1578
Pr -,7M T A,PPLIC-ATION FOR:
.addreSS:
Des<ripT.tOn:
coed Tax ID
1
' I
Budding Permit Application
commercial Residential _—
P--!e,R None: — Left Side: j Baca Rini Side: ______ _-
S?;Do<ks =rOni
fC^t tunaw0 TO e pe rrnt un •P_r ChtS �ermrti – v •« . .. _ _
Gas Tank
Gas P:p:ng _ ShuT.iers
✓'echa"Ca.;
–Sorinki?rS
� Ge^grater
e�-?c
of Ing _.
Sewer Septic
I 15..1 !.It iittes:
i _s' CCnst.-UctiQn S -
Lot NO.
Block NoA
./ Windows/Doors
K.ce-
Building Height: .-
1 Sr nk L I
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. V_a_� CO np3nv: Ills,
Address 1(OS Tor'^ana, i
' �rU a ? v�� State.
i yndi }lo��a .
Fax:
City:
.i Coae _ �^ lip Code: 3293-' =ax:_ I___ -_'/No
7
Phone No.—
I 1
if different Fill ir. fee simple T "tie Holier on next page ( ,.:
gym SL3e Or :,oun'C�, LiCenSE'. the Owner listed above i
f Commencement is required.
if vaiue or construction is 2500 or more, a RECORDED Notice o
DESIGN
Na:-ne
:.address
C:_.
7.p
NEER: Not Applicable MORTGAGE COMPANY: — No, App!icabte
Name:
1 Address:
State: City. Sete:
Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Namc: _
Address. Address
City
=ip' Phone. Zip: Phone:
corri-nencec prior to the i55uc':'1 i:2 Cf a ver.mFL.
St.:uc'e County makes no represeritadon :hat i5 granting a permit will authorize the permit `^oiler to build the subject structure
whtct7 is in conflict with any applicable Home Owners Association rules, bylaws or anc Covenants that may re i h;: or ?ro vbr- vUtr
Structure. Tease consult with your home Owners ASsoc ation and. review you. deed `or any restrictio;+_ which may apply.
•r• consiue•atior o. the granting o- this requested permit, i do hereby agree t`•at 1 wilt, in all respects: perform ^he work
accordant= • eith the approved pia -Is. the Florida Building Coces and St. Lu Cie Coun*y Amendme.
'.')e fcliowing building ,7@rT.it 3FpiiCa CiOnS ere eXemDT Prem -inG ergoing z :uii Concurrency review: roorn additions;
aCce5sory S%,cTures. 5wiri.ming pools, fences, walls, signs. screen rooms and accessory uses to 2ncther non-residentcai use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your playing twice Tor
irnprover^ encs to your property. A Notice of Commencement must be recorded and pos`.ed en the;obsi e
be`or2 the first inspection. !f you intend to obtain financir,�(�' r.sult wit'? lender or an attorney before
rnrv! t^ ncin2 work or rec(ArdinR your Notice ^f Commence --z n
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STATE OF F;LCIRID
STATE OF FLORIDA
COUNTY OF tP
COUNTY OFA
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Persona, Known OP Produced iG+2nti5Cet:Cn
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Type of Identification produced_
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Cor^rnicsio% NCC
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NotaryPublic St of FloridAsha
MY CommissionlmlG 115290
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R a'•" S e d 07"'; 7 r' Ili E -4
'►�; Ashley M Antonelli
lir_ My Commission GG 152970
,,,e Expires 10/18/2021
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