HomeMy WebLinkAboutBuilding Permit Application r r r • �Arr rr
Date:
Permit •- ` '
xr ru.a-+cr t i 1T^•7B;y't+:j. V
Building Plarmit Application
Ranning and Development&Nm
Building and 03de Regulation Uvidon
11 Mr9inla Avenue,Fort Plerce FL 34982
Phone:(772)4. C• F-
F9WlTAFF1JGA'flC)N-FOR To Select from dropbox, click arrow at the end of line
.i j�. x�rqa.���.:;.,.r '1 is r e tN r 1f i1,Fh•-�rF.l:Yr.S���.�..`ave ..gam ,t:�O�1,A`:: n;}av�; 1v.t'S7,I L i.,I R i:y 'er•�� r rr�y�y' r....y _ re
^ry r9•x�./P,�tl''!5�:e]l5� l3/k -CF•.F'J��jP-i rr I[ul�l!!l'AE'4:F'f../'•V�``,��4'3 h.9',�,{,d;i«YeF.rp.t "rN?� ,�s�N y''�,I'�'S�s;tP F• 4)t.. 4" 7-.r.+5•Y^C'( ;'r 'l �f�„��, 7d<1,�.frryc T -��,yfuYj
f`x�t"S1-eYc1S:•:;-..{..:v..... �l:l'^.�'rfila:�.t_�i=�":vw�:��i!r.e trJ�.';`�au�u.:'�:l�kll.:•,:;�JR�1���"k�',�x�1r.'u..:�r}1 s:.���1����.".�:�'.rf i1r` ��._.�,.'�..�z.�.��L:.,.�i::!lw��u!J�r� fy.�-F.+ jYL "7�].I.i.,�
!•• �. •I Wa4zts
c• Description: a �' fi
r_ r
••- r ( V ••
L4-OOo ,3 Lot No. L4
Ste Man Name: Book No,
Project
Setbacks Front Back, Rght Sde:-Left 9de:
5..;.t
1 f r���ak'
l!d��rJt!�rwYe.�l.:5�r .�r.tf:.1r,��c ij4�"}�(iq`xi+r�f 4li4 yl�`fi, �? ,'4i g:ttl7vf i;u^
2, � .lR1r1 .t'4t"wr 7s e....r,� tV."!4. vt7s rt nJigliyl'< r ) ftp,�F t: 35I S9
I.ir! 17rF"�C"."' J's1�;llal'��fi'Gt � �1 res'�� �•sSrx� u\ tis<t y ��`�,,:91�„'`cs; :;�Tr ,�,t ^.�
t.ry c�4 y
- .!i,.�Y.. .u::.F. �rla.a.r. t4.1�.�.t.. ..t r �.�.u. w, lllr•.':�.[_:i..... .aF'� ..�' "'�.
bt.'�`f.:t' " r 's'va r C•Vr' ti"tfl7j m',i'�"„i� a.tiW cM--, sT,•�r n 'i�lx'-rN'r v r�'r r�""�A��r 'r"' P N: •C;.
}r\�Pl:1��F-ifJ���.11-3',� ix}ICt�i������fZl �,El��jgqy`�1 tL �r��}ELAS '"Ysy��(,:,�p 4 'T7�r�>.�t �'4�� 3r _r � ">?�` " r xp'a��r< ', F��•�- �!� 1J �N
k'TY 2 >. ><:♦� -�. f ,s..:'} Aaf l+t+!P t"'r r a ! '� " r r c r ��` � J � F ro( t}t w.�a �..M
.e..". ...N,.4�i.�:.1'J:__.1. .t�.. I s. .....kr........tJ.,.d.�i.,'�•,...�aoSr.P�:,.... _..tux! 57�•r..L1 `kM �`r�rt,��l.d!,k_,.:ul..mu}.fN,h...,r.. .a1af it..G:b',.4..,s'.�....'y� .�,.fli:.,�
0 HVAC .. ors
KRumbing [],"-priniders OGenerEdor
• .y of Construction: a. • "••
i.j141V�-j`4�. �Affr.7.1 i >�t�'�:_:aI,c..z.i�,'7.,.uGa.t_S.r i_5. ,.,cl,kL..m.!:r•,1t}I`PN",�ahY.u�c,.Li.la`}..u.n..¢.v...�.,�/F�.`{4F^''r S•ji r}�i>`4.>wrtir:+,ly.u3•.i'�IixC9��rhP!rtri.?@ttt'r,•,J 141
Fy_r'.CY�1F1EIFi
.t ,r'rP�-rP'•T.rSj�,`rIIle��r.°q�1,�.3.Grl; ]1rp17,u:�;rj..`d_Ylyrda�5Y�l�l,im,.:cr,r.,l..-ins'I�+1YS�r�tJk9;,77,F,iau'r.al..{..yJ,tk�.tN'uGu'tt}cTL.:..^...y d;et:.tw rt�{r'irS,fr 1.i.�,:q-3Jx"ni-..t«qrsrl!1"IX
{N,
11
4
,71
q!
M1 r 7
•• L R _
05/02/2016 MON 13159 FAX 7728782717 Art Stover Plumbing i4002/003
a
DESIGN ENGiN of App ica MORT'GAGE03M PANY- ! Not Applicable
Name: Name:
Address Addre-s I
Cit ate: Ory', date:
Y�
75p: Phone! ?p: Phone: 1,;
F-9MPLETTTLEHOLDBR ,_,Not Applicable BONDING COM%NY J' Not Applicable
Name: Name:
Address Address: i
City; aty: i.
ap: Phone' Zip: Phone: t'
I
i certify that no work or installation has commenced prior tot he issuance of a permit.
a.Wde Cbunty,mak. no re re l tenon the is+ rant ng ac�atleni�vyi11 auYhori r an�voven tsthf t rnair a rk b�r rohi dt
which is In conflid wit�i an plM a home rs u1 b 0 Y .
structure,Reese oonsult v�it your i�ome Owners dation and review your deed for any restrictions which may a0piy.
In consderation of the granting of this requested permit,i do hereby agree that i will,in ail respell 1l perform the work
in accordance with the approved plans,the Florida Building Codes and R.Lude CbuntyAmendment i.
Thefoliowing building permit applications are exempt from undergoing afull concurrency,review:room additions,
wry structures,swimming pools,Fences,wails,signs,screen rooms and aoc&%ory uses to another non-resldential use
WAFtNING70 OWNER Your failure to%cord a Notice of Cbmmencement may result in your paying twice for
lmprovementsto your operty.A Notice of Cbmmenoement must be recorded and posted on the jobsite
before the first in i If you intend to obtain finandng, mnsu{t with I er or an attorney before
commendn Wor or r n our Notice of Cbmmencement. {
i�
( S
_9gnat ure o eri kern 9nature a ntr or cense er
STATEOFFLORDN NATEOF FLOG OK
ODUNTYC)F ?"'- t uCi C OOUNTYOF S CIJE
_ i
She forging instrument was acknowledged before me The forgoing instrument was acknowledged before me
this2 day of &1" 201 by this" dey of 20 by
(Name of person acknowledging) (Name of person acknowledging}
(5gnatu a of Notary Public-Sate of da) (Sgnatur f Notary PUblia ate of Ri a)
Personally Known, ORProduced Identification Personally Known Le:f- ORProduced Identification
Type of Identification Produced Type of identification Produced ,1.
D.BtGIVdON Oommission No,
* MY COMMfS$ION 6 FF 065801 i idMiSSION ti FF 011,4801
E!IRES:Ocher is,2017
PIRES;Odd&120117 At
�3orrt tiotitN1
tlWDa0811FioiatyBmia� I,
Revised 07/15/2014 1`
FEAEVVS FRONT MING SJPERASOR FLANS V1ETAMCN �TATl1ME MANC VE
OL LINTER F;BAPJU F;BAF-U FEVIF-N FEVIE N { FEMEBN FEASIV
OOMRETE I;
' INI11Al.,S
i