HomeMy WebLinkAboutBuilding Permit Application ALLAPPLICABLEINFO MUST BEOOM REM FORAPRICATION TO BEAOCBT®
Date: ` Permit Number: 5G 1 d 31 as
AP
R`21 Z0�5
Building Kermit Application
Banning and Development�rvioes
Building and Code F egulation Division
2300 Virginia Avenue,Fort BerceFLW82
Phone: (772)462-1553 Fax (772)462 1578 Commercial Fbddential
PBW ITAPPL1WON FR To Select from dropbox, click arrow at the end of line
PROPSI9000 W. , LOCATION
Address: 00 G,9 S.¢//e S 7— Fot•f ✓�/U�
ee-
Legal Description:
Property Tax ID#. /.30 " 6 /S ' o/3 f- &o o -L? Lot No. �
Ste Plan Name: Block No. 7
Project Name:-b om i,7 C �C� o S�,'+z a
S:tbacks Front Back: Fight Sde: Left Sde:
DETAII::®DE9Cf�IPT10N3:OF W,OF�C � ,'`
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OONSTRR_ ljq INF=0f�111A110N
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i tion wor o e e orm under is permit' r. . appy:
El HVAC El Gas Tank ❑GasPipin9 Stutters_ ndows/Doors
❑
Wi
0 Bectric Xplumbing �rinklers a Generator 0 Fbof
Total EA' . R of Construction: R.of First Floor:
Cost of Construction: $ //'00. d-� UtilitiesSrvuer F-1 Saptic Building Height:
OINNI L OQN TRACTOR ` _
Name i hi ele oS k0 Name. Tu L t y
Address /SS/ S��, .Y ,��E �"eF-�• Company: ('e.,et;S
Qty: S C. gate: FC Address
Zip Code: 3 yy.s3 Fax Qty: //.fC gate: F e
Phone No. 7 X02 v2!S t16 4S 7 7p Code: 3 y�1S.Z Fax 3 35 a 6 pPa
E-Mail: Phone No. 3 3-7 :9,0g,>
Fill in fee simple Title Holder on next page(if different E-Mail: esr%j AZuQ -fon
from the Owner listed above) Nate or County License: G,4 C / y y /O3
If value of construction is$2500 or more,a RMORD®Notice of Commencement is required.
�JPPLHUIBYTALOONSTRIJCT(ON Ll6�I LAW INFOI�MAl10N
DE IGN6RIIENGINE2 Not Applicable MORTGAGEOOMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zp: Phone:
FEESM PLETITLE HOLDER _Not Applicable BONDING COMPANY: Not Applicable
Name: Name: —
Address: Address:
City: City:
Zip: Phone: Zp: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
3.Lucie Count makes no representation that is granting apermit will authorize the permit holder to build the subject structure
which is in oon lict with any applicable Home OwnersAssociation rules,bylaws or and covenantsthat may,restrict or prohibit such
structure.Rease consult with your Home OwnersPssociation and review your deed for any restrictions which 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 accordance with the approved plans,the Florida Building Qbdesand Et.alae County Amendments.
The following building permit applications are exempt from undergoing afull ooncurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory usesto another non-residential use
WARNINGTO OWNER Your failure to Record a Notice of Commenoement may result in your paying twice for
improvements to your property.A Notice of Commencement must be recorded and posted on thejobsite
-before the first inspection. If you intend to obtain financing,consult with lender or an attorney before
commencingg work or recordinq vour Notice of Commencement.
ure of Owne?7 Agent/ Lessee nature of Orntractor/License Hold
STATE OF FLOM DA STATE OF FL-ORI PA
COUNTYOF 5"P• �-v ``� COUNTYOF . Loi
The forgoing instrument was acknowledged before me The forgoing instrument as acknowledged before me
this',* day of Qk p{ %\ 20 IS by this-,X1 day of 20_%by
(Name of persbn acknowledging) I (Name of pe on acknowledgi )
(Signature of Notary Pu o-gate of Florida) oa (Signature of Notary blit Sate of Florida)
G\ o\ 20 v�Ns o<�aa
Personally Known ORPf o uced Iceoga�e \�0�6 sonally Known ORProdu
Type of Identification Produced t, of Identification Produced
�'�• !� \a° it ;.' k tion �9 ��� w.
�l l tn• 0� Ona +5<�r` oda y E' #� i?'� „w•
Commission No. �'E��Q�I ( o��\SS�r�a�� Q�rnmS$SOn NO.
yeue.c a �y Goto ��009 ,,, ao :may Go oa�N.,!•
10,
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Revised 07/15/2014
REVIEVVS FRONT ZONING SJPB:?\/19DR PLANS V133UATION SFATURU MANGROVE
COUNTER RRABN REMBN REVIBN REVIEW REVIBN REVIEW
DATE
ODMPLEfE
INITIALS