HomeMy WebLinkAboutBuilding permit appAll AFIPLKJ BLE INFO MUST 8 E COM PEETE 1) F OR A PPlrCATIEIN TO SE ACCEP'TEV
hermit Number,
Building Permit Application
'Ycwnmg a?Td LtewApmme _5efvkes
Hu,rajng and Code JRequiatron J7iWsian Commercial Res'ld e n q i o _
2_= Vr'ryonro Avenue, Fart Pierce F1 34W
Phone: (T72) 462-155-3 FDx; (772) 2-1578
P E R M IT AP PI_ICAT ION FOR: -
PROPOSED IMPROVEMENT LOCATION: - -
—
Property Tax ID #:
�'� �,
0-
r� 0 1 tot NO.
Site Plan Name -
Prod Name: _
EL lock No.
Fu E TA I LE D DES% RIPTION 0�_ %VORK.
42A''il �i cif r• fY :%w �-. •'1 i
Ncw Electrical Meter
5eoond Electrie.�l Meter
CONSTRUE ON I N FOR MATION:
Additionail work to he performed under this permit -rherk all that apply'
fillechanical
Icctric
CL3s Tank
PlumNrtg
rotar sq. Ft of Construction:
Cost of Con5#ruckion; S J5 0M -`' A
OWNEf AESSEE:
Gas Piping
_ Sprinklers
Name— - f ti
.Address-l' _ -
oty: 1�71 cr( e State-
7rp Cade: _`2L2. Fax- 21V6
Phone ND. '?-)2.- 33 2 - any 3,LL
Sht2mg-, _ Windows/Doors ptmd
Ger1eraW — Root Prtd,
• Ft. of First Floor_
Utilities.. -Sewer _.Septic &a ildirpg Fiei!�ht:
FIE in fee Simple Title bold er on next pa;g ( rt clitFererMt
flow the Owner Irsted above)
CONTRACTOR:
N amp:
Co nip.)ny: f-'rfj:l C r—
Address qt4' P'e _
co, - se t
Zip fie' 6-7- _ Fix: A
Phone No
5z" or County Li�xnse ft 3 r
If value of con st ruction is 25M or m4rl�, a RE CORD Ea Notice of ComnMM"wlent i$ "MUirad.
If vsdut of HAVC rs $7,5W or more, 3 RECORI) f [] Not ice of EoTnrrra,w,t rent is reWlre&
SUPPLEM ENTAL CON STR IJCT10 N LI EN LAW I N FORMATI) N:
❑k
Na ra ae:
Address=
.Not .A2p::cable
city: date;
Zip, Fhone
FEE SIMPLE TITLE EIMDER= _ Not Applicable
Na me:
,address;
City,
Zip: Phone=
MORTGAGE COMPANY: � Not App I ica tale
Na rne:
Address.
Llt�r. State=
zip; Phony:
BONDI N G COMPANY: _Nut Applicable
Namt':
Address- _
city:
Zip- PFhorke;
OWNIN CONTRAC OK AFF(DVIT: Applicaticm is hereby mAde to "tairk a permit to da the wqork and isMotion us indicated.
I + that no work ar installation NO-; twmrnenced prior to the issuance of $ gpermit,
54. Lucie Count makes no repriege tion that is igrwr fin@ a p rmit aril. authorec the nm it holder to buid the Subject 5U11CtUrC
hich wis in cor�lFl with a" apallcah6e Flome Owners A&%qM#fvrr rules, bylaws yr and covenant thy# Mao restrict or pfohlbit such
structure. PI a consult +nth your Rome 0i%1Crs Muxiaftion and review }roux deed for anV rrtitriuTions which may apply!_
Ire consideration of the granting of ENS requested permit, I do het ,! mic that I wit, in all respects! perfom UK work
in atcordanrx with the upp4rpej plans, the Florida guiding Codes and St Lade County Ame dw-en .
The foUawing 4Uitding permit applications are Pkempt FfOm undergoing a full conaarrenq reek r; roomadditions,
orce7xrw strwtures, swimming p*01% fences, walls sighs, saetn e ms -and aowssury uses to anotfhm use
WAANI a TO OVMER: Your blure W Record a Natioa of Commencement may resutt ix paring twipe tor
i rnprove meats to your pn�pe rty. A Notice of COMrneme meat m ust be reaor d in the pti blic records of St-
LiicM! County af1-d posted -on the Jobsite before -the first irrspection- I F you Intend to obta 1 n fi na 1crn ff, wruuFt
with lender or a n atturrhehr before cnrn o ririrrft uvark n r rpnnrciina wni ir Nrtir-& ryF i-rsr,lrmnr1e•nrr3o*yr
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STATE OF FLORIDA
COUNTY Cr
Swo rn tc {-or Dfhrmiedl and subscr3bbed :�Oorr me of
r Physical Presence or _ Online Notariizati)n
this ; �' �das} of �- by
Molder
STAR OF FLORDA
COUNTY OF -
Svmrn to Jcr Whrmedl and subscribed b-i-face me OF
__1Ph)rsica1 Presen,ru- or Online Notarization
this -L —5"dayr of � wt 2020 by
Name cf person mgki n� 51atement. - bWrne of person making statement"
Personally Kmwn OR Produced
T,mc of Identificaco
Of Wry 1PUb,ir.- 5tai a of Florida 3 �
� t
rh No- i � (Seal Z C A.
15 g t;
U.9
REVIEWS I FRONT I
ZMNC
CrDUNTER REVIEW
DATE
DATE
COMPLETED
Perwnally Known OR Produned lien of catiun
Type of Identfo
azure of o V pw ic- State of %ri
n a
rnmassion No. 6C-T I s
IYLAF45 I VEGE-rATIGH I SEA TUR'ftf