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HomeMy WebLinkAboutBuilding permit application PUCAB1tE1NFaMUSTBE` +DMpCoE6 PM-i I'1i0111MO-019ACMUD, Perrnit;tVurober:,,,����P 1 : } t i Whi -Pe �t. �at:Ecatra a>>> - r i F�lihraing:ar��sl Dearia�5me�r Seriics - i fi!wi�ing phci`'C.ocR��ulAtFon Drvlsro,� � .a.f.07 raA cfort�ierce FL 34982 � i tlor�e 772{462, 553 Fax,{?72}452 ri7 Corrercralx Re Won, P�RMiT,TYPE, - dd PriopgrO T-ix 1"-w. _lL f 71�. S - -. „ 1 Additional"*io t performed under this p+rmit the afl that apply,; °,.;-•NiecfamEat Ga"s�Tark: ��asR�pin� Sitters ;1Nindouu`s"Jpoors= _••t:tectric P[umbtng prinkiers Generator} �R Mich TIP, q,Ft o Can ti uct�on, ,Ft of Fist F�aor3 _ _ _ __ Oft of Canstruc[iQn $ C} `. ;lltiii ies ••_Sewer 5epfic 9611dingafi6t& , ____• ' Namp ,.�l�Gsz.�m :�...�.� -;:,, i+.t�me• .' } Address• co' mp-ar►y City„ _ .State Address, , State, I?toreNaI � aX.. 4 Eilt in fee.s�mple Tats HoldecaD next page( i{ferent ?E Mail. r .-.. .- _ - fromthe thuner��sted;:abave�' State or County t.icense j ff value of conshuCtioh�s:9'2500 ot;more,a RECORaED woUr�'of`Commencemet�=isi�equ'red, u`" -� ! tf val ue of HVAC is$s7,5Q0 o[more,,.a RrECORDEJI dtite of.Commencement Is required.; N ESIGNER/ENGNE -=trot Applicable— `;j�pRTG"/XGE COM[�A�1� � Leat pp�i�f�J�' as _. A ? I�farnIN- A6 _ -.,- ..� . .._�_� _ .._,._� ... �_�..4.., - .. c , Stake s Cit { Statec I .P ane= .� .,a ��� •� PCiQrtes" 4EESIMPi n'CE�:F OLIDERz Bf�A1DtNGC+EiMPAN1[ i� `�3ppt[gf3�i3 I . t - Addrss - d ss re = C•i C. r Fhdrie _. .. - --. .. ..._ Phode"�_... _ _ W Ii+R/CONTE EtQR AfFlft�VlT�Appi>ccatian is hereby 1m a to obtain r;rmi to da the wc�rfcand instaiC4!01 .z Phil = is cerh r that no woi c or r Ilatian hasxomni- d pnor'to_the issuance of a_permit: StF LrcMe_Cohnt makes n"o represenat?or t1at�s'gc;'ntin'g a.perm " nilutilidrize the permit holder to 6u�il the sittiect stfuctc�t ,_ which is tn:conflict;with,ai�; sappliciblesHome Ouvn Association butes,Eaylaws orand cayenar►t that may restrict-or prohibcGsurh structuCe Pieas�consWt wltfi yourH4me EatinnsersA�ssc�atlonand re�neVtryr�oui deem for:agy rest rions.whicf�=may apply: tiro deraifort of the, rar+Un {�isrr�gaested,�yermjit_t do herby a ee that i�nriti incl{res�yectsr perform tieworie: c i g w g t:*!r iS. a 1 a ' X lrx F't x l accordance with the approved4pians,.the:=fforida;.l�uild ng.Codes anc 5t Were purity Amet�dments< } 1-he l b1fdWi buiv�d ng"�erriii app�teations re exempt frori�cftrdeYRdfnR a foil cc�r► afrent}rrrecnev�r room a_dd�twrtsr _ accesso structures mt ingpc�ofs,,fences„yralfN si ns,;screen.roomsand.aceessorvuses;toranotlier-non-resp Central usef �1"�IARNING TO O!!�NER.YOUR FARURE TO RECORitlt A NQTI�E OF GOM IENT IMA1f RESULT QI[1fOUR PAYING TwICEf FOR If?N>i'ItOYE1YlElitlS TO YOURPROPERTY k'#Nl710E'OF rOlYlltl!<:11fCkEMl1IT MUS1'f BEY RSC©RDED� II1D°k fif QSTED ON THE JOB SITE BEFORE THE,,�F RST,INSPECTKW-IE 06,INTEIIS> To-�OBfA$1 FDIIA 111,-:CEylifSilt.7` , Wi1N kdtw ERmOR AN;.11Tiotittlt>=1F=1 FO�tEaR colt riNG.YOUR NOTitE of ca ° Y L f >S n u e of Qwne�r/Lessee , rt,tactor as A -_-6 r Qi�mert 3'Signature cif GontractorJUc„ap a HQlde�' I, $TATE OfA�� A � $TATE OP K'OfilDA R[/ COVNTY�OFL Ek e romping, �gstrurn t tivas a cicnow4edge efor�e=Rie t�tse fofgoin-g in frument was aeknaw g4di a ire me` th(sclay Qf _ 20: by =thu day of 20 'by �Iatne ctf pecss�R; »alung stateme[t, Namebf person mekmg statement fsersonally Known: OR Produced identrf catiors Personalty Known�OR Produced.'Ider tificatiod 7ypefiof Ccf, tificatio Type o Idertt1.radon, e of Nota fi {o rich otar�rFub!!a N19rtatarke of'Nota PuBi« State of Ftor�da ,.egmmission No: ”- CommiisstonW6 w. it �xruruori No•GG 9 , 1l EWS FtidNT I ZONIlV6 SUPEkiVISbF P1/ NS VEGET�kT1�N StAT,URtt Ex MAR ORP,CfE COUf�iTER REVIEV REVIEVlt REI/IE1N REVIEW REVIE1f11 REulE1N GATE RECEI.VED QMPLETED '' -