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HomeMy WebLinkAboutBuilding Permit Application—x MORM 1 5 MORTGAGE COMPAMY: NotApplrcable DESIGNERIENGINEIEM NotApplicable Name: Name: Address: Address: city: - State: Crty_ state. - Zip: Phone Zip_ Phone: FEESIMPLETffLE HOLDEM Not Applicable BoNDMG COMPANY. NotApplicable Name: Marne: Address: Address: Zip: Phone- BUpX, Phone: --. fl�iflltiERI CQIIITRPiCT RAFI7Dvi I : ApplicatiOn is nereny roaue iU uowin a [7einn1R Lu uu uia sFuuen mi �u �A Launuti„ I mray thatno workorinstailation has commenced prig lathe Nsuance of a permit St. Line Coup�sy makes no representation that is granting a permitwifl authorizethe permitholderto btflIdthesuh�ctstructum whichrsrncorsFlictv4thanvvapplica6IeRomeOwnersAssoriaffunrules,hylawsor covenantsthat�res�ictorpro%i6itsuch structure. Please consultmM your Horne owners Association and reviewyour deed foranyt�5c5onswhkh may apply_ in considerationa thegran ngottiiisrequestedperfn%Ido€rerebyagreethatIwail,1naftrespectE,perfbrmthework in accordancewiththe approved plans the Florida Building Cades and St Lude Co" Amendmentr. The following buildinggennitappliratiansare exemptfrm#ndergoingafullconcurrencyreview:roomadditions, accessory5tructurw, swirniiing pools, fences, walls, signs, screen morns and accessory uses to another non-residential use WARNING TO OWNEM Your failure to Record a Nance of rmmniencement may €esult i€n yasff paying -twice far improvements to your property. A Notice of Commencement trust be recorded and pasted on the jobs to be€arethe-first inspection_ If you intendto obtain financing, consult With lenderor an attarneybefore _..Y. �.,1...,T,.rr�►rAir�fiird n��nmtnwrar-csYniatYf' l.Ul7{i{lG{141ia uvvaatiaaa aLi.uauMa. - — --------- a 5' aFCurytra, or%License Haldar 5rgnatttre - owner/ F.1'ssr ej tt cWra%Agenttart]wner SCATE OF FLORIDA rIy()F Indi STATE OF FLORIDA couiTycl Indian River Theforgdinginstramentmms a&nowledged bL-fore me The tbrgoinginstrurnentwasacknowledged hefaTeme ti&—L dayof 1NnvRrnhRr .ZII,,,,1.�9hY this,Z.dayuf NrniPrr�hPr t2019hy D iel F Daniel FPkPtP _.-- Name ofpersan rrralftstatement Name of person reafdngstatement PersanItwn_ _X_ OR Produced iden0caiion Personal[Vxnomm X ORProduced ider fficaiion Type ofIdEafficadan Type ofldenii cadan Pp duced IJ2�� Produ (S of puhlsc of Florida Florida) Con, alj PI CID No (Sear �; aW Notwy Pubft lka of FWAm PaEneE>t Dyes-HaE+e Pamela DyW-H Comm€aaion GG 25811 ion i5 q; F�xp€"FW OMID R re+asroarzaz SUPERVISOR P E MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW I04EW ©ATE RECEWW DATE Compmm Rev. S,/;QII