HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAILAPPUGM LEINFO MLISTBEO[IIARFI®FORAPFUOATION TO BEAOIID
Date: Flxmit Number: kI d 6G dos
RECEIVED JUN 3 0 2017
Building Permit Application
Ranning and Development S;rviaes
Building and Code Pagination Division
2300 Virginia Aveiue,.Fbrt Rene R_34982
Phone: (772) 462-15M Faoc (T72) 462-1578 Gbmmerdal ReSidential .
PERVIITAPPUIMnM FOR To Select from dropbox,.-click arrow at the end of line ,Q c J�
Address Iy'
LegEd Description: ,37 i ( /�ac. as lA JW (w) 0
PbpertyTexlDIt '4 SCq -12,0 - c»l2 OCSID -O Lot No.
Ste Ran Name: Block No.
Project Name
89bacics Front Badc Rght Sde: Left Sde:
qo �Wc. • 0-r Q.,Q Qne
EIHVAC UCasTank ❑GesFi
D Bectric O Rumbing 118prini
Total 94. Ft of Cbnstrucdion:
Gust of Gbnstruction: $ 9 "75S
ing U Stutters
Ns FIGenerator
_ R. of First Floor_ _
Utilities] 5%werSeptic
0
OWindowdWors
Rpid"d Roof pitch
Building Height:
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Name , ggd L, n5
Names
Oornpany. Cs-� h-xa v V kQ-;
aty. '�} .`�' e rg c., aateiF�P
Address: S RI D- i � , PT2
Zip (bde:34 9 S `1 Fax
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Phone No. I -) L- 2dao - LJ4!q
Zip Oade5ygQb a Fax
EMail:
Phone No. 't`t'L^ UaC>"'LR-tA
Fill in fee simple Title Holder on next page ( if different
EMail:6�r i NAN
from the Owner listed above)
Nate or Cbunty Ucense:�!� 7-S La S a
If value of construction Is$Z500 or more, a IMfU®Notice of Cbmmenoement isnequired.
ME
[Loll
Name:
C]ty.,,?A-. 6kState: �_
Zip:340,$ 3 Phone:
FIESIMPLETITLEHOIDER Not Applicable
Name:
Address
MORi•GRGEOCIMPANY: Not Applicable
Name.
Address
Clty: State.
Zip: Phone:
BONDINGOOMPANY: Not Applicable
Name:
Address: --
City. I (sty:
Zip: Phone: Zp: Phone:
1 certify that no work or installation has commenced prior to the issuance of a permit.
no
the permit holder to build the subject structure
r and covenantsthat may restrict or prohibit such
3ed for any restrictionswhich may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in acoordancewith the approved plans, the Honda EMIding mdesand 3. IWde CauntyAmendment&
The following building permit applications are exempt from undergoing afull conamency review: room additions,
accessory structures, svuimming pools, fences, walls, signs, screen roomsand acoessory usesto another non-residential use
WARNINGTOOWNH2 Your failure to R=rd a Notice of (kimmencement may. result in your paying twice for
improvementsto your. property. A Notice of Commencement must be recorded and posted on the jobslte
before the first inspection. If you intend to obtain financing, oonsult with lender or an attorney before
oommeReinavverk or recordlna vour Notice of Cbmmenoement.
The g instrument wasadma Medged before me The forgoing instrument was a knowledged before me
this day of 20 Lq_by this 25� day of kmtx 20E_L_by
f637-� Q 2
(Name of person atlmowledgng) . of person acknowledging)
Type of
Commission No.
Revised 07/15/2014
Identification T
=ANY L BYRNEB—
alpF FLORIDA
Cow FF967191
Type of
Commission No.
of Horida )
Identification
PUBLIC
ATE OF FLORIDA
Ccm,6 FF967191