HomeMy WebLinkAboutBuilding Permit Application AIIAPPLICABL.E INE. MU E CQMpWr QfQf APPLICATION TOSEACCEPTED
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DE5IGNER :ENGINEER: Nat,APplicpb(e MI RTG/ GE COMP14NW Not"
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EEE SIMPLE TITLE'HQM.DER Not Applicable BQNdING CO11tlPANY Y Not Applicable;
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OWNER/CONTRACTt?R AF,E4DVlT AppIicailon-is hereby made is obtain a permit to do he wo k:and s�rstollation,as:st�dicated
Gcertify thatsna.work,or:installatson has commenced prior to tihe Rssance of a,permit,
St:Eucleoun, makes Ito representat�sn#hat is granting a perfnrt will authorize the permEt:Fofderto butii�the subject s#ructure
whrch,rs_rn.con �ct:tnrith.any.applical te.Home O.wners:Assoc�ation,ru(e ;bylauus ar and-ncovenantsthat may restrict or p'tohib t such`
stcuGtu e.:,Pleas acorasutt.witlx;:_our Horrte;.Owners,AssOnatian acid reu�er�i your deed for any fiestr ct"ionssty-i eh may"apply;?,
In.considers#ion of the grantrngof th!s,requestei#perm,rt,I da_terelay agree drat 1 will,:�n all respects.perfarm the yvi k
�n accordance w�tli the approves!plans,the Florida Building"Colles and S it uc e. uritVArnendhientsr
The fotfawsng iauildrng permft applications are exempt Ecom uniergotrg a full cdnctrrrency review room atlrirtrons;-
accessory_structures,swimming;paols fences;.walls,signs,screen rot?ms and.'.accesso .usestoanother non= al use
"WARNMNG TO`OWNER YOUR FAILURE TO RECORD A:NOTICE OF COMi!lYiENCENENT NAY RESULT U1t 1 OURr ?'AYING
TY�IICE FOR MN,PROYENEM. TO YOUR PROPERTY; A NOMM: OF COlY1NENGEAiENT MUST"BE`RECORDED AN1
P05TED ON THE JOB SI BEFORE THE`M"IRST MNSPECiiONt IF'YOU kMNTEND`TO;OBTAIN;FINANCING, CON5Ut1`
WI1H_YOUR_LENDERsOR;AN.ATTORNEIt.'BEFORE-RECORDI1VGYtIUR NtICE,OF COIHMENCEMEN7:''
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Signature of,UuvnerJ Lessee/Contractsr as Agentfor'Owner 'Signature ci.f tZ ctorjEicense Holder
STATE;OI`Ftt3RlDA + Z-ve STATE 61if.-PIP OF -
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The tng rnstrUr�ge, t�was acknowledged 6-efore;me The f sing mstrurn n ;wras acknowledged before me
this _!IL day of�_ Liltt ZE} hX I&ay of
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Name of.petssn making--statemen' Alame of person mawng state ent.,M _
Personally Known_OR..;Praduced icientifiotton!.. _._. _ Personatiy'known tOR..P, otiuced,ldentifcatron -.
' iype of Identrficatrorr Type of Idenitfication, ,
'Protltaced G
_ Produced
(S�gnatur of Notary l?ubisc Stat F a " tgn re;of Notary Pu lis Sta o a }
u• tory Putatid State of rt a r
a* V tatyPvbitcStateafflo
. ; eltssa L 8utterleid ' !leItssa L Butterfield
;:COrr1l711SStOn N4, r a Commiss�oh GG.3 1'n sston No - �V tU�`� 'Ys= .�Q$$t& ommissmn GG,3o20 5:
0211412023;
REVIEWS' FRONTONII�G SUPERVISOR PLANS s VEGETATIdl1I: SEATURTLE MANGROVE;
COUNTER' REVIEW^ REViEUU WEVIEW REVIEW „; REVIEW, RFV;J
DATE
RECEIVED
DATE -
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