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HomeMy WebLinkAboutBuilding Permit Application To: Page 4 of 5 2015-10-27 17:37:55(GMT) 17726733383 From: Maritza Ramirez-Carpenter ® �9..B.::".'.CCEPTED ..�:..:..::.:;�::: ....�..: :.. Permit .. . � �iiarn6er r it 'ECEAVED OCT' 2 8 2015 ":.... ':.:. Piannll?g-and flevefoprr `Bulfding.and. ode Regulotion D vision, 2300 Virgnic Avenue,fort Phone;:{772}.462 1 Fax:.(772}4624579..' . .-:Cam-(nerdy [ -Reside6tlal PERlitilT PPLICATION:FOR:.:. ' J.ega{.DescriptIon:,,. �a Pro -faz:i vn_ 5�Iay Property Tax iD.#: 4� M '�2 T . .���, � ' - ' €ot 0. B ock:No : Project..i�ame:' Setbacks ..:Frcrft F3ack; :Right:5ae:: de: --,--- �+i3 F'. its�ti= 1 �'•:..x y l R- -.. 'm'. �,�� ' 3} y �El �c i( s it III K*�y;i '�`}�V?. SAW .1 1� 'd. �.� � �. -.aA,�p� .;P •�fi.h�Y. 2. ' s .22 d ittona wor. to a:Pe armec. un er t �s.permit c ec. ..a .t...at-apply. :. _._iiecha.oicai, :.....: {aS'Ta:nk. .... . ..... _ as:Pipi€. .. ..... Shu t#ars :.: _.... .. :-_ 1/Vis�cosf f�r�ars. _ Electric. Ppurnbing _ Sprinklers. Gngratnr Roof otal.Sg:Ft of Construction.:: Sq...Ft.tsf First Floor: Cost at Coristruc#ion:$ a tltiliese.S: ' Sewaer. seoiic Building Fiei h . ,Name �s✓tJ� lt' Na.. e, i r Cor,6any ,11 C.'l State: ,Address:�:?�i �:�" Zip.Code: W Fax, tv: State ZipCocle: �§�"iJ FF4x:,a'- a` Phone No� ... , .� --` ` Fiji in.fee si P6e Tide,ialder iqr�.next Pag :�if i3if ererit E-(Mail i (Z -A<.e-��,��� from the OWner listen.above) State or.Co.unty:License if value of-construction is 2500 or more,a RECORDED Notice.of Commencement is required. To: Page 3 of 5 2015-10-27 17:37:55(GMT) 17726733383 From: Maritza Ramirez-Carpenter DE IGNER1EFnN @1NE R.: !Name: Marne: -. . Address; ----- Stade; .� City. City: :.„ ' PhonesMcip FEE SIMPLE T.IT E HOLDER:, *Not App.6icabie. � 13.O i]1.NG COM.PANY.: . ..Name: Dame.: Address: 0ty ! zip:, Phone, Phone: Zip:. OWNER/CONTRACTOR,AFFIDVI 'a_Applicatian.is'hereby made to:obtain a.permit.to do the wrork.and irstai#ation:as indicated; i:certify.:that naiCork er irtstallatpbn i7as cor►�meneeci prlgr.ta:the issuance ofa pern?iL., S.f.I ticoe Count` makes no representation that is grantinRa permit will authorize the'per-mit.:holder to 1)uild thesubject.structure. ' w$ii.ch Is'In ccniliet with an. 'a.pplicable Ho.rne.:Qwners.Association rules,byiaws.or andcovebantsthat rnay.festrlet.mptohibit such str�:tture.:Please.eonsultwXth your#come owners lssociation.and sevpe�n�ycssar deed frac any restrictitins:whith rr4ay... ppiy- In..consideration;of the granting oi•il'iis:recuested p&rrnit;.l ala hereby agree:that i evil!,in W[respects,_periorm:the.work. ; In act ordanre Ite:appro eif.plans,:the F arida B Nino Cedes.anti.Vit.i.udig,County.Arnendr:dents; The following building permit applleatiiins are exerrtpt.frorn.:undro's:ng a full cont urrertcy review:warn arJditivns, accessary'struct`ures;swimming pools,fences;walls signsa screen rooms ai d.ice ss6ry uses-to ariother.non-resident!al.iise WAR$�@$�IGTO:Q.WNER;1€`bvrfailure.'t€..Record a.Notice of.Commencement may.-result in your paying.twice.for...: imp.rovements:to:your p:rop.!ar°ty.-A' otice gf-:CQmrnencement:Must-be.reeo.rde. nd posted on:the jobsite. b Rare the fii in pect6®n:1. You intend to btairr r►aociri. ,consult ri h[en or.an ate .I�eyr.b�f®r "Cornmeacing. �car�or recoadii� y�pgr.Notice o Commenceinerit jt Slgnature:of Omer/.gent[lesvee/Coritractor' Slgnat...e of contra tor!Llpense.Holder . _. 5 'E:OF FLORIDA STATE OF FLORIDACOUNTY.'OF 'COUNTY-Of . ....... i . l The#or. oink iiistru .. rs �y.as:.ckno. {edged efore-rne.. .... : The f.r ©ing.ins..tr e t' as:acknovirieogg4.0fgre.me..'.. . . thiS� dayQ€. �_ Xy f' r t0i�y thas_ dr�yuf � J �' :4 �l�l.. : 7. (I :a.rr►eo€€iers©riacknowledging) (Iia.mso€'Iaersan.,acknowledsirig} i ESigratu.re r3fi U.otary:PUblsc ataxe.ef Flsrida).. jSignature.of 4Uotaxy.Publrc-s?'ate o€:Florida}. Pe'rsonaily Knon. TYpeofidentl t:atron: $ ;� ,'. �h8 ProduEed '=' :; A;tY C47ri PRtssIC?N.r F 23fJrf46MY COMMISS!iaAl� _ pradacetf. i Ccrrrtmissson:i�o.. . : . :..:. .: .:. :....._..:..... ........ . .. orrirni=osion Np. .. . ' PE 'VISOR PANS=pCT:• ZONING . VECETRT.ION -SEAT}RTLE.. : . VAdCROV E.RFVIENS TER MOUNREVIEW REVIEW REVIEW REVIEW REVIEW REVIEW ... ®RTE.'.. .. .. ... .... RECEIVED _�_t _..... BATE . - eV.:' I