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HomeMy WebLinkAboutBARLOW RESIDENCE AC4 ALL APPLIC . LE NFO UST BE COMPLETED:F Date: )R APPLICATION TO BE ACCEPTED �J Zo?jn ]] tPermit Number: Permit Plonningan DevBuiidijg Per elopment5ervlces Application lid Bu!ld/ng and ode Regulation Division 2300 Vlrglni Avenue, PhoFort Pierce FL 34982 46Il ne: (77 2-1S53 Fax: (772) 462-1578 C01r1rperClal III PERMITA PLICATIONFOR: Residential To Selectifrom dropbox, click arrow at the end Of line S I 1 Address: q Zb l T� r4l Legal escrip In 1f 1 {-),_ I Property Tax #: 3y -off I Site Plan Na r Lc No, llli Project Name L✓ Ot r BI(ck No. _ i I Setbacks F nt i Back: ' _ Right Side: is E a Left Side: 1 + T 2+o w H tiona w to a er orme un er t Is rmI+ 7 c gy f' rf HVAC s Tank a I;sS,t. peit-c ec µaf,;, GaaPPY Ga° Pipigg _Shutters Electric I� !. 0 Plumbing " Windows/D ors Total Sq, Ft of onstruction: �SPI;Inklers Generatorjj�� 4�(Roof Cost of Constr ction: $ �j a, — UtiS of First Floor: "� I�dl s _ lities: Sewer ire Septic Building Heigh �II' Name a 1J 1 � Address: t-!ti�(4 U^ Name: Sf r �/o s � IIII /L n City: QgY7 l vt Company: O Vii tL(n 1 Zip Code: °ISa Stat'e�- Address: I� T Fax: v , Phone No. - -1 City; t u✓ } , v 1 IIII E Mail: ' Zip Code:?jN°1rj tatd: ft- �� Fax: Fill In fee slurp a Title older on next page if d,,: Phone No. 17a - Yb �� 1 -Ila: CI •I from the Own r listed above) ( �;:; rent E-Mall: State If value of const uction I 4r County Licenser-� co '�- - j ' $2500 or more, a RECORDfii (j,;Notice of Co ilk , mmencement is required. I I ! Name: p MORTG"ECOMP Address: I Name: Not Zip: Zip: ' � Phone. `�"--'--Stal;dt'�LL Address• City FEE SIMPLE NOLEaER: 21p: Phone:`` Name: _ NotAppl aTiie 6ONDINCICOMPANY: Address; Name: —Not MY: Address: Zip: #I Phone: City: i certdy that n rk orirutaJlatia^has �.i�.cleC°'_.In mencadPriortothe Issuanceofa'er .akesnofeor.,�.m..c.._.�_.. P mpt. incon slderatlo of thegranl! ""^" M� oc!at3ohandtiV67Rur .•,ucovenittlts t:inay ctorp' in 2Ceordanem ngof this revyuesDed Rerrria; E do yo !fariny!estr ions wdv1 may apply. th the approved plans the Floridaernldln 0 fw*ftanagree th [aA M ON respvct3, pafnrnt the vrork The folkwJngb Itdingpermdtappticatlon5are eNe19& tYAmandments, ecceswryatruc res; swJmming pooh, %e�.wa � underg0in soar cnnePrre" reylaw: ream additions, WARNINGS TiOWNER Yorrrfaliuri � � z screan room ndar .MrY uses to anotfuer Improvemap to ourgr Recard'Ji.latlre _ noisrisidenlialu bef the N in Asctlon If tY'uA Notice of E3'tmence�a"n' mgs�t be may limit InYngr paying twke com encln dIY° tend to obt in ftnanci , consult wlt�lentla�rand poested on the 101 _ nit rNmen M!--- 5 A F ' RIUA Hold COU NW O OF RIDA COU t] Thetrur�nt}vasadmowl I(�7 y t bl-a0 rtgiftwument this da N 1<-J fills 1 r apyo{ r,Vnwledg d before me Y# Owe orPart" edaiowlodgtaii ISlgrtaturaofA IaryPuhNnStateof orkta {8lgriieture of Notiry Pybbc- state of Horldr 1 PefSena OR Protuced loin ,. ,f' TVPaaf denriN flan rkodiNced tifkatJon. f ersonalFyKnown__. Oft Produced tdentltkatlon 0minlWon GG 717f`9 - 1YPaofldant(fi'mdenProdud_„ ce�_ (Seat] 'tld' Co mmlrgon Na: G G D 7/ /S 'r' llevls6t071512014 ' Miles; iSa Affiti erneom.otlrrBxgrlAL+iar4sn4yr � �*�yor'` DYt9E&MI REVIEWS FRONT XNINICr SUPi•:RVI5QR P"S COUNTER REVIEW REVIEW REVIEW RtV1EWON SEATURTLE MA OAT@ _ REVIE� RN COMPLETE INITIALS j PM- il;j i