HomeMy WebLinkAboutBuilding Permit ApplicationAl L APPI ICAE I E IN FCI MUST BE COMPLETED FCIR ARR L ICPITICIN TO BR 110CEPTED
Date: ilerrnit Mire er:
Building Rem it Application
Alain nimgl acid Dutiielapniant 9erriass
8 u ling) a i c I Ca ( Is A e g i ilatin n DA ii:i ion
JM Virg inia Avnnun, Fc r Pia,iica F[ 149W
III ane: (77]) 497-1553 Fa)i: (772) 492-7578 (lorrlrrleticial Residentia
PIRMIT APPLICATION FOR: Tki Select from dllopbox, click annow at the end (If line
Addr49!i :
Legal Deiari t•on:
-kc) -
11ropertylaxlD11: �" 1"C0
Site Plan Narne:
Pnojec Ilarne: ,S (M -
Sett aci s Ironi Baak: Rig1 l gide: left Side.
I at No. -
0 loci No.
,QnaI %A orK torra rms a unasr 1 nc9 peamn — a i
*1 Tf
Gag Tin C Gas F ining
Elac nia ElPlurot ing C 9Rniol leas
Total Sq. Rt o'I Conitructia n :
Cost o I Conai ruatia n: $ LA q OO,�
MV111,
un ers IN indovis, IDa a rs
Generator � 1 viol LRoof pitch
S 11. of Fint Rloor: _
Utilitiei:Semler 11 Sept iii
P a rn e`
Aciclre tr.3 g or i
ei1}l: Slate:
Zip Ca cls: U 1a:
PIone No.
,
R -Mail:
list in 14 siniIN Til Ie Holder on nix page ( if cliffs rent
9rom l he Clwnen Iista ( I above)
Building Hei€fl:
Name: S.
Compan)1: �' C
Elcldreess�s: 5
aity: 1 f I S1 al e:
3ipCacle: ZZ�3a Rafe:
F I one No. — —S
1-N a lair 6 "
F. I nA
Slate or Count y I !can se.
If value of ■a natnut ion is $2900 a r more, a R B CCIRDED Nol iee of Coni rneuaeni ant is required.
ME
DIISIGPI IRiIIINGIN EER:
Narna:
Plddrle!l!:
Cil y:
Zi p: H t a na :
FEE SIMPLE TITI I HCII DIR:
Name:
/Iddnes9:
alit} l:
Zip: Phone: _
Nol Applicable
S1a'1a:
Nol Applicable
MORT{IACI8 COMIPINY:
Name:
Alddiv 1l :
Ciiy:
]in: Phana:
SON 001 CI COMPANY:
Name:
Add re!l s
City:
Zin : Phone :
I a,irtiN tl atna work orinstallatian his aorrminced 11riorlo11 a issuance of permit.
Nol Appliaa t le
Slate:
_Nol Pip nlicable
St. main Counttyy real es a s yell rase ntatia r that is Ira Ming a pe rmit will a utl a rite the pn rm it holder to build tl a subje cl struc tire
ti-it is inaonfliclvultl amiapplioatle,
lameOwnersAssociationrules,I)llawsarandaavenantstlatmay rostricor11ratilituict
strucure.Please(1onsultvilth11aurHome Ouiner9Assoaiatianandreviewyour deo dfaranil reitrictionivitsat mayapllly.
In aonside ratio r a f tt a ®ran ting a f this m e wasted pe rmit, I do t erel )I agree tt a t I will, in all re ip ec s, perform the wa rl
in aceordan Ie with tt a approNied plans, the Rlarida Building Cocles and 9t. I ui ie (louat) AnlaniImeets.
The following buildinal hermit applications a re esaempt fro rr undergoing a full aonuirranq re)iieur roa m additians,
aacessorystruaturns, 9uiimminal peals, fences, vialls, signs, 9areen rooms a nd aawssorl uses toanotl or roa-residential u.ae
'A ARPI IN G TO OM N ER: Your 'lail a to Reaord a Not ice of (I ( m me ince me int may nesull in you in pa}ling lwiae ilor
impliavements'la yoLinprone .ANotice c Commencement rnus1 to neaanded d posted on tt ejob:liIa
beilorethe >9irslin:ln(IaIian.i auinIendIoobtainfinanain@,consull Ail nanallcnney11lora
aammenciuewerkwr nevourNoliceolCornrnenaamanl.
Siguatureal�r LaAe,ICoatractarasA31entfar Owner 19i®natiirwtfdofitracor,lliaense Holder
STATI CIF 11
CCIUNTY OF
T1 farloinp instrument wasaaknowledllell t1fare me
this -f dayaf 2I}l
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