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HomeMy WebLinkAboutBuilding Permit Application �f Ei 4 Aif,,�PPiyt,�A61?E"t�1iFQ`M[�SCBE"COMPL'ETEq����11�RL[CA'TaN,"�t3'BE�ACC�P7El - - Date:_ .,_ . _ .- _ .. Perrn,t Nt:trnber•r _ ._. ,._. - ., h l+ Bld�n ;Perritt ApgpFf�cation Plannrr 'and D'euelQpm lit S,ervi 0-- 1 , $ftl��a`nd CoteRe�ulotron�vrsron MOO,VrginRoAit 64- 014,*,�t 9498 1 Phone, 74NIX( . x _ '--- RSP©�� A-d&.ess 8129 Links WElil ort 9f Luctq Fl X498@ -S 971 Piro a Tax tW ALCk-N BCoc fYo Pro3ecCvN �rae l R -pipe l2af'2nd Tcbld Liries ff7• Quf ibtisa. moll-c"m1prf ;itiAaster"tathryornF2Fs�nks,Shawear`Toilet�Guest.batti'oori 1:Sailc,;"Ts�itet,�hower Gliddabafhroom 2 Sifik,T606CISttower 'Others,Kitehen l�Vash�r;UUafer heater,Lau�dry��`ub,Setvrce to'house,�ce,box and 4 hose bis -- ' WWI REw Acllitia[workfo be_performed; under this;perrr►i —;checlall t[itjc _,iVtechan�cak' _Gds 1`ank ,_Gad Pip.�nga Shutters; .�-�!tllrfclows�DOarS ; EfettriiAFlumtt`ing Sprmklers Cenerator? ;Raaf .Pitch; z TotSq Ft ofConstrucign ,-___. _.. . g Ft 00Firs Floor . T10D`DQ Cost..af`Constructcon $ --- � � _ ,Utl7itiiesc ,: zSewer . . :Septa Building MWAWER�Wi SM.- `<.. Fi USA lnc f Nara adv. � , :Address: on pang � Choice Pfttmbmg.Soluiio�ts ' City w State f Addtdst- 1 .. _... _ . . ,687 SV1fiSo0tFs Macedir[3tvd; _.. Ctty. !?hone_ To: Zip Code,3499 Eaxr E=l�tlacl _ N Phone No" ,i Fiftinf6e-sbittleHolder;vhvneferer&t: E-,Maif�tchoi�plumbing�oltfionsa�gmadccimd _� GFG[42 -31 dm the.Owne Irsted aboGe Statie Qr Cotu�ty,�Lcense If'vafueof'construction�s$2500 qr more,a RECORDED lYotrce pf CorfirKencement is requirg�. If value of`HUA��s`$?50p ar moret,a REGORQED_I�oNce of f.�m►siencement is�equ�red, �= ' i n x .d a" sf ' 'QEStGIVEi JENGiiItEEli:­ _NatxAppljca ill' MORTGAGEXOMPANY ,_Nil# N 7DdA e N7ame ` y Name City G�r� Shat €' i Zig� Piinne, �t�. Phcix�e.� 'FEE,SIMPCE"T,�TLExxHOLDER No Ap ltcabl'e + "B!DNQING COM ANY !"Al �;�I p licabl:t3 Rtame i igldtess,' - Ciy Glty .a a Ztp:, Phone Zip: �Pharie r - OWNER/ QNTEtACTC�R'AF (L?VIT A treat b isereb made to obtain a Permitto�o tk work>arid Instas;rnd�cated� E ,. 13certrty that�rt�b worKor cristal{atrori�ta�cor�mertcecfprrorty the a5suanc�of a�e�4� �. ' 5 �ucierCo_un�r mattes.rho°representatrortthafiisgrant ngapecmt wiliEauthgr�zethepermrt izo[c�er to.build tias�ub�ectst�uet►ir .„ wih In co WrE}:aTrJC applteab�,tom�gvunrpc�atrgn iutesrbyfau�s ur ad.cavenarttsthat rriay,rsrQrQrohrbs ; u�h a s1Utt jr,.Pteasaosuluvrtti yourom Ovu#retsAssaFtation+ancG,re�rrevrr your ceiffr any restncti,Qris wf�ch rrray apply,, N {rr`�cQnsrdera�od afi`�he grdrrting oft thrs requesteif�rermrt�t des be"tr~by agree'tha�{Kwr{i,rn all$respects,�ertorcr>�the work ` rn zrccordance wcth�thi=approved pians the Fonda Bur{drng�Cod�end S�,[uc�e�Cfiun, :Amendments . Th�;fc�ifornr_rng tzuEtvdng pQrinct`appJieatro�r�iar�eitem�rt.-lioirt,_un�ierg4mga full coniurreneYreurevr� room add�iQns� - accessory strcictures;,svir�minrng pc{ols,fences,walls,srgns,'scFeen rooms.andaccessoFyr a"sesrtaanather non-resreiitsat use . "Wi4RNIN TOGO. UWFAIL [E OF COMt41ENCEMEEtf MAY R.E �`?' "�'^■"'°',A ""'�'r _ >z T0.�1►ICE FORv1MP S UR;PROPERTY, A',JMOTICE'OE EOM CEMENT' MUST BE F Czitra�eu P'01TED ON' ,,RE Jd E�BEFORE:THS°FIRS#`11BfSE�!ECT10N lF�l{Qtl Ov 018T G,.�QNSU�.T o-. i�YRw YOUR= ORiA RIERECORI�ING`YOUR;'NOI[CE;O EN�EI�IEI�CF.' t s Signatir.eof©wn"%� � e .r_w.�tractoras ht;�o�Duirner � Signatureot`G �tracto n...-". .a.,�__. STAT 'DF FlORIDI _ STATE:OF F RtrDi4 CtJUN :OF.. `cl' COl1NTXOFk. The forgoing m was acknorNCedgetl befar rrae Tkre foigorng istru enti n►astacknouvledged nefot me r tn;saay o c � Bio 1X` by this day°of x 1. �;Dame:ofperson.rnakirigsfaterneri . ngstaterneot_ i SPersoWY-Kff6dWy OR;Ptodu.ced'Identifcaficrt Personalij/'Ifs{ovrtrr [?R Produced i[tehtrficafioC�._ .. Type o (clpntafication — Tyo--o f W40, rfgtra0 Pr'Qd ted_. Produced. :r -........ Y (Scgnature of 06ar1r Fu6t�c ate of Florida) (Sigriature;af{votary Pu te: . riz�ana alalic. Aruna Venezrancr _ 4 KOTAt it Pt{BLIG" Gommrss�on N6�,- � � tJQ7Ak�YPtS {) Cdi»mrssron�N6_i ._«g ri .: �STA7E0( �iDA � A7E OF F!ORtt7A 0arti5 :C3Gi85914 ?°ComrrM�.CG1855 - p,rsJ'1�41�Q VEGETATION, 5EA-TURTiE MAN [ OVE 4 ftEVtES1VS: FRl7NT ZONING SUPE&VISOEf PLANS A: COUNTER; REVIEW ? REVIEW = REEW !y REVI_E,W j ;REUfE1lf1` E,IFFY ` DATE # RECEIVED DATE 5 .'COMPLETED '