HomeMy WebLinkAboutBuilding Permit Application ALLARUWLEINFO MUST BEOOMPL=FORAPPUCA11ON TO: •!!: :!
Date: sNumber:Building Permit • •
0= RECEIVE D OCT 15 2015
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and Code%gulatlon DvWon
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Phone: Avenue,r• .> 462-1578 (bmimercial Fbddenflal
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10/15/2015 THU 10, 14 FAx 7728782717 Art Stover plumbing 0002/003
DE9 6NGNE R `Not Ap, MORTGAGEODMPANY: Not Applicable
Name: Name; —"
Address, Address:
City: ate: aty: ate:
Trp: one: ZIP: one:
FEFES M PLETTLE HOLDER Not Applicable BONDING COMPANY Not Applicable
Name: Name:
Address, Address:
aty: City:
zp: Phone: Zrp: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
9t.J cj9G�unlrn%egno representation tha is�rant'n sip rmlt vrill authorize the ho�derto build thasub'ect r.U�ure
whl Is Inion Ict w th any appllaaq�e Horl�e ars a Ion ru e�,bylaws or an oovenan s that may,restrict dr rohlplt such
structure.Please consult with your„oma nersMiatlon 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 Codes and$.Ueda(buntyAmendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fenoes,walls,signs,screen rooms and acce<a�ry uses to another non-residential use
WARNING TO OWNER Your failure to Rgmrd a Notice of(bmmencement may result in your paying twice for
Impprovementst0 you property.A Notice of Commencement must be reoorded and posted on the jobsite
beforethefirst in n. If you intend to obtain financing,consult with I der or an attorney before
commencin wo rdinq vour Notice of Commencement,
5
Sgnature of Owner/Lessee/Agent gnature n ctor 'cense Holder
STATE OF FLORI DA STATE OF R-ORI DA
MUNTYOF `3T- LVOAF C OUNTYOF !q •lJ+Gt
The forgoing instrument was admowl edged before me The forgoing instrument was acknowledged before me
this IG5 day of PCL1 __ , 20 ISby this�5 dayof �A(��+2. 20 iS by
(Name of person acknowledging) (Name of parson
acknowledging)-
D 92V-__
(Sgnature bf Notary Public-3 f Rorlda) (9gnatu of Notary blio-RWe of Florida)
Personally Known X ORProduced Identification Personally Known _ORRoduced Identification
`type of Identification Roduced�r:; �� _ Type of Identification Produced "':.
My COMSSI ON Il FF 0888811
Cbmmis5lon No. * *�S:Out*08 2017 Commission No. S-WRM.00I0t,?16,2017
k,,.v 64*dTIn8WpplNo*ykv1m Hotd�dl4rupladQdN y8fNklt
I
Revised 07/15/2014
F;F-MBNS FFONT ZONING SJPERMSOR RAMS VEGEI-ATfON �ATUFOI.B MANGI;ME
DA OaUNTER feAM FeAEVV RUEW FTVII'_N FSAV FeARN
OOM RHM
INITIALS