HomeMy WebLinkAboutScan 3ALL APPUCABLE iNFO MUST BE COMPLLIED FOR APPLICATION Ti} BE ACCE ED
19
Date. 611/2.0�!
L'Am "L-3" im
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Permit Number.-C
Building Permit Applica...".tion
Planni",'ng and Develeaparrent Services
B-(z?11d-1hg and Code Regulation aivi�tqon
2300 Virgiinfi'a Avenue,,, Fort Pieizee FaL, 344ir 982
Phone-.: J772) 462 77*f) 462-1578 Commerci*a�
Address,* 9323 Breakers RAW
Legal De scitpoonV PALM BREEZES t�LU� {P� 4�-32) BLK 9 OT 16
R e. s,'1* d e n t 41* a x
ID#
2310�50&wO172i000-9
Lot No,,
Site PlanCa R...,.Ock
Project Marne: --- Terren..,ce Hicks
Setbacks
Front Mark
Rif t SI'de: Lift �ic�e'
50GAL ELE�TRIC WATER HEATER REPLACEMENT
El�ectric
Ll Pfumbt*ng
Total Sq,, Ft of Constructlon
Con
Cost •
ICPiping
Sprinklers
1620
— I_!1 �iy11��r • � if
apply:
Sh. utte rs
enerator
Sam. Ft.. of First FIloor
UtItittes'.
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Name- Terrento Hicks
Address: 19323 Breakers FZ_
ciftve FL
F
i
�IIMrrl�MiiYX, o�+ti�r�a
State:,
4LIp Cocij',
- 34945 It
Phone No., .561"91 1008
E-Mafl.a, �
*It* fee S1*tup le Title Holder on nett page if d-'ifferent
l
fro the Owner IiS-'rted v. owalvie;�
Sewer
ndowsI'-
IN
Nd
ip*PtIC Building He
Roaf pitch
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Na. me: DIMITRE 805EV
Company: FLORIDA DELTA MECHANICAL
Address: 8402 LAUREL FAIR CIR SUITE I I I
clty�: a �NIPA state: FL
Zip Codies 33610 ���9. 866-w2l9avO729
Phone No. 86%&&21M880
all: FLPERIVt1TS@DELTAME�:.HANICAL_GOM
State Or- counly Lice Fi CFC1425917
if value of construclJonis $2§�l0 or more, a RECflRDEg Notice of nrnenterr�ent as requirec'�_.,2i,,
DES-fG-N--ER/EN45IN EER:
4y 1
:'- NO— W.-
Not Ap-plicabte
N am le : Fitz AlbertBoorne Jr
A-ddre,SS a 3112 W Dixia BUYD
C F T RE.-M-E S Statel.
z1op: Pho-ne-_
FEE SIMPLE `39ITLE HOLUS..
iNd'ot Appl*cab'....
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MORTGAGE COMPj1@10 Not �Ppllcabile
N a e * DIMITRE BOBEV
Addless 3112 W ix-ie BLVD
1z
cityl TAMPA State.
Zip* Phone%
BONDING COMPANY,
A I�, ~r
PP
fNam4 * �.._
Nam e4%
Ad 0 ress,,,:8402 LAUREL FAIR CIR SUITE 11Ad
dress:
f Sc
citye
Phone,ZIP *OL PhoneV
OWNER/ CONTRACTOR AFFIDVIT
! certify that no work or installatlon his
9. In - SL Ill ' +ed.
" Application is hereby Ma dew to obtai n a permit to do the work and 1 nstallation as indica L
0,,.M0MFne_nkw0."ed prior to thel -issuance
, of a permft:,
LCie !!,,"I !J111111111111111111111111 + X
e t t b Ct
P Cl ::s bje ,.trU---....ture
St L Coun, makes no;representation that ant- '11 author-ze the 11111111) 1
wh;chl's in con i is g inR a I er o uflO H
Uct with any applf-Y...-ILable Home oviners Ass�Orllat" Wes bylaws or at id covenants that may restr, or prohffift such
',MA W I on r
i o n
structur=.. Please consult W"Ith yout Home OwnerS-,, Associat nd
In cOiluid�r�tic�;� o f�
in accordance with t
he granting of thgis requested permit, I do hereby ag,ree that € will, in all respects, pefform the wvM k
he approved plans, the Florida Building Codes and Sll,-.,L Lucie CouEn-'Zvv Amnndments.
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:utt�wirig iiUilCiEdi g p=imtz app I clation s aCe exem pt fro m u n d e. rao Ing a u I I Cf?nCui'3`eni.l :'tloiTl adCjt6E7P2§,
acc-essory struc-it-Ures, swhrr~a ng poo1s, fences; waits, stgns, screen rooms and accessory uses to ancatt2er non-residentfal us,,.
tAIARNINGT0 OWNER: Your failure #0 Re:4%rd a N�ti�e a# �..e�nent rnay It in your Paying twiceiirtiprovements to our prope ty% A 1Icati�e cif rnme��cerr�e t must �e record �� and 130Sted on the joT �:
lEQ,
before the first inspection,,, If you' n+Lenob..kain financing, c? 'Ire de'r � anljliiz
nej� �yor
t
em,commen�ckcr { to�rrec
rV�
Signaiure 6'f owner/ LEIssee/Contract"or as Agent for %Owner
STATE Or---, FLORIDA .. I
.. 1 lllll.. I )-� <
COUNTY OF
the forgoing instrument was acknowledLo.,-e�u before me
This � davof Y_� "'��� by
Name of person rnakirg s��•>e=nt
Personally Known P<_OR Produced Identificatllion
Type of ldentifl4..,,ation
Produced
J
.0
Commission
Rev., 81.-2/.17
S- 7St.
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The fo,,""goin� i�3st�urr��nt %;as ���,�ovvl��ged bet'ore me
thl"S d a-y o-i'
ft
Narn,pl-.. of -?ae� sari making statement
Personaffy Known OR Produced
Type of ldent�fication
Produced.,
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