HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALLAPPUG4MEINFO MUSTBEOI)M LEAD FORAPPUOkTION TO BEACCB'gM
Date: 3 1Permit Number:
Building Fbrmit Application
Ranning and Development SuMoes
Building and rode Fbgdation Division
2300 Virginia Avenue, Fort Reece FL349M
Phone: (M) 462--1553 Fax (772) 4621578 (bmmerdal Fbddintial .
I PERnITAPPI GOON FOR To Select from dropbox,-click arrow at the end of line
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Legal Description`s-V-U,- `?C.rr► l�n;�c 2
Property Tax lD # 3 yWC% - s �O — O Z,�M$ --ice- t Lot No.
Ste Ran Name- Block No.
Project Name:
Setbacks Front Badc Rght Sde. Left 9de:
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❑WAC U (3asTank
0 Bektric 0 Plumbing
Piping U_atutters
nlders FIGenerator
Total E4. R of (bnstruction: Ft_ of First Floor_ _
Oust of Construction: $ %R 18 Utilities L_I Stever 0 Septic
OWindowslDoors
FbOf Roof pith
Building Height:
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Name Ltr✓' V C)r s�
Name: \ I
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gate'�i
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Entail:
Phone No.-1 -Z^ o- 4-kq-tq
Fill in fee simple Title Holder on next page ( if different
E-Mail: 8t&► ® CCN74 ck !apt
from the Owner listed above)
gate or County License: `ASD
If value of construction is$2500 or more, a FECOFUED Notice of Gbmmenoement is required.
Name:
MORMAGEOOMPANY: Not Applicable
Name:
Address c SO Sul - Address
city: State: City: State:
zip�RS3 Phone:—) �.- Z� e-4Li,,'t y Zip: Phone:
FEE9MR.ETITLEMLDHR Not Applicable BONDINGOOMPANY: Not Applicable
Name: Name:
Address` Address
city. City.
aip: Phone: Zip: Phone:
1 certifythat no work or installation hascommenced prior to the issuance of a permit.
& I.ude (bunty maims no representation that is granting a permit will a thoria the emit holder to build the subject structure
which isin conflict with aiy, applicable Home 0wfk rsAssoaation rufe�, bylawsor and cov�antstha2 may restrict or prohi sib
structure. Rye consult with yow Home OwnersAssoaation and review your deed for any restndionswhich may apply.
In considerEtion of the granting of this requested permit, I do hereby agreethat I will, in all respects, perform the work
in accordance with the approved plans, the Rorida Bielding Cadesand g. Lude mimtyAmendments
The following building permit applicca ionsare exempt from undergoing afull eoncurreriay review. room additions,
accessory structures, swimming pools, fences, walls, signs, screen roomsand accessory usesto-another non-residential use
WARNINGTO MM ER Your failure to Rwrd a Notice of 03mmencemait may. result in your paying twicefor
improvementsto your.property. A Notice of Cbmmenoement must be reoorded and posted on the jobsite
before the first inspection. if you intend to obtain finatdng, oonsult with lender or an attorney before
corms aminctwork or reeordina your Notice of Oammeneement.
SfATEOF 11.10MA STATEOF RJMDA
OOUNTYOF OOUNTYOF / . L. Ii e—
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Theforgoiriginstrunentwasadumwledgedbeforeme 'The forgoing instrument wasadaiowledgedbefore me
this2.�;day of �' U, ti if- . 20 L2by thisaj_day of 'SI.(, nPcF 20 /
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Revised 07/15/2014
Sate of Honda)
NOTARY PUBLIC
STATE 0 k1DA
Comm# FF957191
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