HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dale: F`-(O'Dlo Permit Number:
4dll6
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Building Permit Application
aunvin9 and Component camas
BmminD and Code RePoI a form Commercial Residential
2" vlrornk Avenue. Fan Pnrte it 3499t
Phone: (n2) 462-1553 Fax: (A3)462-15]B
PERMn APPLICATION FOR: AI 4{ 1
Address: 191'A 20� V ralm DA
Property TaeiDB: aH;�—IDOa—(y)G4-000—n IMNo.
Site Plan Name: fork No.
Project Name:
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,(INSfJWCA A/
New Electrical Meter Second Eletrical Meter
Additional worktobeperformed under this permit— Check all that apply:
Xfechmlol _Gas Tank —Gaspiping _shutters —Windows/Doors _Pond
_Electric _Plumbing _SpNnklers _Generator _Roof Pilch
Total SqT Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ t A;,130M CA Ubludes: _sewer _Septic Building NNgM
Name f Name:
Address: M01 0IOIMr {]Re Alll*A Company: l
Cry: V4 %air" State:pt Address:
2ipcode: R,kWOj Pax: City: Pai-yqf,�n"a smote: PC
e: SYlB,`P- Fax: OfM—(@I-.$7y9
Phone No, ElieCodr
E Mail: Phone No I" /J I
FIR In fee RmpleTRk Holder on tied pi(B afferent E-Mall IO(%,li F0AU-e ACb Col..
from the Owner lbraid above) State or County License ePCI gl CP59 r7
Nvalueo —Co"dlon I5 ZSWName, a RECORDED Prefer Nmmm mis required.
I value of BAUC is $T,SW or was, a RECORDED NW loear Commencement Is rebound.
OEGIGNE IIGINEER: _Not Applicable
MORTGAGECOMPARY: Not Applicable
Name:
Name:
Address:
Address:
City: State:_
City: St ate:_
Zip: Phone
Zip: phone:
FEEMMPLETITLENOWERs _Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name'
Address:
Address:
City:
City.
Zip: Phone:
Zip: Phone:
OWNER/[ON MR AFFIDVIT: Appicadon t hereby madeto obtain a pelmhto domewarkand Installation ased[ated.
I [erdty the no work or Installadon has commenced pimtothe Issuance ofa perms.
stluoi makes norepewrostim that lspeninga it will authirlae Me Imfl holder to bWMtM subject structure
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M1ucture�plwsecowwhltwYt n"d;M'a:yourdeedfo` may apq�Ibu Burn
irsouc'NomeO seciions anyresoluns which
In considerable M the pending of this requested permit, I do hereby agree that I editor all relations, reform the work
In accordance with the approved plane, the Florida dunking Codes and St Luck Cuunty, Assortments.
The ldloW ry building cannot applications are exempt from undergoing a full rarwnmry miew: room addition;
accessory stmnwu, weroming pool; fences, walls, signs, screen rooms and accessory uses W another non residential use
WARNING TO DWNER: Yeurfaguni Rewrdl a Notice of Commencement may react In paying Vale for
improvements to your property. A Notice of Commencement must be recorded In the public records of St.
Lune County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender Or an eacrinew before commencing work or recording your Notice of Commencement.
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are reNOwner/Lesxe/[mwactarm Pg cMrP w
SNneW fContra[tor/[i[ense Holder
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Commission No. (sea)w
Commission No. (5eall
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
RENEW
REVIEW
RENEW
REVIEW
RENEW
RENEW
DATE
RECEIVED
DATE
COMPLETED