HomeMy WebLinkAboutpermit appM APPLICABLE INFO MLMT 9 E COMI PLC'i Eb FOR APPLICATION TO Eit ACCEPTFb
bete.
palm it Number:
Ca1
y- Building Permit Application
PiarmArig end 0ewC1bomen1:�rr4iGrs
-90dwnl; On d Coda R 62n Diwisiorl Commercial _ Residentka
2 Virgin a AveffUp, fort PierCe Ft 34982
Pi orie: (772} 462-1553 Fax= (772 � 462• 1575
PERMIT APPLICATION FDR=
PROPOSED. I MPROV EM EST LOCUION.
Address-. -7
Prup" 7gx ID Lot 110_
.�Ite Pla n Name, %lock N4,
Project Na rne- C-
DEfAJLED DESCRl"ON OF WORK.
New Elec#rleal M-en*r Seoorml Flectrica I Meter
ON RUC�I0N INFORMA.nom
Additloniol wgrk t-Dbe p�!rfarrned Undtr;hrs peMlt —check ell ttiaa appty;
Mertdc
Ca5 Tank
_ PlumbIng
TDtaf 5q, F; O�n�S#rurtl�fi: �
C05t of Coestmctign;
OWNEREE:
GiRf FlDlrkit
Soda Clers
Sh„ttvm T WiriddWS/Doom Pored
— Generator X Roof Pitch
Seq. Ft. of First Floor;
Vtikias, _ reh-r — SepTJ[
Addy-Ss'01
�I':!,Cfwtif
VP Codle: 34 Fax- —
E-Mail;
FNI in fee sarnp 10 Title molder on new pagIL I it differwnt
from the Owniar f[sled abn )
Bufading wetht= —
Stab21—L-
NP Code; -30 q 5 1 Fax;
Ph-nne Now -q
E-Mall k ,
Slate or CountyL1cense % ''98
COFACTOR.
Name' (-q-
Compaw=
Ad -dress;
City-<k,i
1`1 walue of cuns#raLtlan 15:25O or mare. a MCORDEO Not;4 4# Commencaawr t is requlr#d.
If value of HAVC, ii $7,500 ar fnam, 0 RECORDED Notice of CommR`i7cement Is rmgvla`W.
S U PPEE M ENTAL CONSTRuc f l C1 N LI E N LAW I NFORMATION -,
V ESW&NEIIENG] N FFR: _ N of APPI Itabde
Name:
Addy-ess:
0ty: StAke;
Lp:., Peons
FEES W PLE TrrU NC}4o FR: ` Ncr# Applicable
Naine;
Ad dregs
Clty
21P: P ho ne• -
M ORTGAG E COMI PANY: Not Applicable
Name:
Addrms5'" —
City,, -State,
Zip; Phone;
BONDING COMPANY- _Not Applic.a bte
Name:
Addraw
ck)r
Zip; Phone:
OWNER/ CONTRAC jkmovfT: AppfiQ&Tj6n is hereby+ made W obteln J� prormlt to da the wgrk and :nITallwd-an
I rmIN fiat no work or inmlaelon has cqmrMen fd prig to the Iswanae of a permit,
�6lndleated*
$t- . �klnr�,rr retake no riepras�m lftin #.Kt is Meng -a permit will a Qrire the rmlt Folder en build the �ub'e�t �Ict�r�ne
who, In oorrflIII with a ny apple-Cklble FIB QvoI Asscxiat�orti fui.I Waws or an oovenanU bWk may. re �14it ILKh
5trud mnL Please consult Math your Nome Owners Assoel"on and nawllew your deed far any hostricTlor1s whl aw a w
in -aonsl,d atlm of the granting of This Tequested Wmir, I do li-ereby agree that I will, in all rftpmctI perform the work
in 2=rdan with the approved Olipris, tihe FlorWa 19uilfing Codes and -St Ludo County kne drri".
Tree folloMng building Petftt a-P01MI-I a,* axitmpt from urrdergQng a full soncurrency r ow; room addltloK
ec.cessory str:=Ur-h , GYAM R ngpools, %nr wel3#, signs, SCreEn roams WB 00ory USPA to -another non-rrsidenflul uee
WARNING TO CWNER.b Your f ilureto Hewn a Notic* of Cvrnmonmmem why r�tit In ping twice fur
improvements to ypur Property. A N otiCe of Commerrcernerrt must be recorded In the public records of -St.
LUCIle County and post,@d on the jobs fte before the first InspeCt[on. If you I rntertd to Obtain Ananci ng, consult
with lender or an arttam before comMandnig work or recordl rr q4 r Ngt" d of Cara mancernant.
--
as Ag-I for Owner
STATE OF FL
COUNTY OF
41
ii@Fratrafe c r/I Holder
STATE OF FLOM-
A
QDUNTY OF
!�Vm
to (fir affirmed) end sat ribed before me of rt to for affltmed] artid subuYjbed b-IwL�- me. of
lahys al Prey oe pr Online NoWrltaLian � P +,+sicai Presence or Ortillrre N�M72�orr
# is d#� 2QZD by this l , 20W lbw
Na me of perscn rn +long statern-I Name 4Df perswti makjn$ st3, Met
Personalty Kn-Dwn 1 f OR PrncLucsed Id6rM lcoMon
T*-04 of Identincaoon
Producl.
A4
[Si$n;hture of Notary Public- of 7.A,��
_ C
Crornmissian N-o, [ 'p IRIQA
O=iMi�_
C 1 tur 1�
R IE $ 1 RO�I ZON lf+Dia +U PERM SOR
�4JN MR REVIEW REVIEW
OATf
com
P9MnaI1Y KrxMNn OR P110duoed I denTificadun.
Type -of Identwi qoA
Fr�dr,o�
[Signature of Ndary P jhl Ic- Sta :D1,44 ❑*wj. j,
ITI�1'alESIBlif'rI"LIC
PLANS I VEG-ETATION I SEA TURTLE I MAN GROVE
ILEV115W REVIEW REVIEW REVIEW