HomeMy WebLinkAboutBuilding Permit Application FROM :DNS Services FAX NO. :7723446402 Jun. 24 2016 11:41RM PI/4
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Building Permit'App ic8210 .1�J
PlannUfq irrrd•Qe�rrlbpmentSetvbces I�E R:�'I"I"i"f�;;;
OvAdding'and.Code'Rogukftrt.DAdslorr 5t. Lucia
23001/rolnIOAwnue,Fort Pienw a 34982
Pholte:.(.?72)462.1553 Fax:1772)462.1578 Cwhmerdali Residential. x
PERMIT -PPLICA` ION:FC3li9 Mgchaftal
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OHVAC' Gas Tank Gas Piping Sh . ers. Windows/Dc4ors
1 Elenric t�._:,I plumbins- Sprir►klers IG.,,,!Go t rator. Roof
Total Sq,ft of Construction:.._. ,5 '.Ft.-of Fi •Floor:
Cost df.Construuctxx;:$ "� 5n-OQ Utilities r: Septic Building Height:
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Name Name: Dom :
.Address:• Company: Fl.O WQA AIR COND
City: Out State:FL Address: t4 SWSAI-T5RR
bap.Code:�._ Fax: �� may: PO ST LUCIr sem:
Phone Not. �4 jj-6n2�'7 E � Zip Code: 933 Fau:
Mail:. Phone-No T.2--%"7.87
.Flil b f4d simple-We Wder on next pW(Ndlff *nt !r-Ntall; � ide. me DndlUortin.g@yahoo.c:orn
from the Owner d#Ad Q1w4} $to%or C� .urity•License:6AC18a4359
if value of ponshvdlon W$x500 at mores a-IMCORDT:D 1 Wce-mf Cammmoon t ismQuIeddi
FROM :DNS Services FAX NO. M23446402 Jun. 24 2016 11:44AM P4i4
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:: . f3E51GN�R G1t EElt:. ,_Not Applicable MORTG `: Not i�Agsttcabte
NatlEte: •Marne:
Address Address.
City: State: Cfty: State.,-._,_.�,,,
Phone: Picone'.
lfE SIMPi.I:'"I`1Tfs HaLAER. _,,,,'Nat Applicable RONDIN COMPANY; _,Not Applicable
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Not
Nami;:
Address Address:
City:
City:
ZIP: _�1 hh ne: ZJI p:
Phone.,
OWNW, CONTRA olk AFFIDWIT.:Appitca.0n is hereby made-to obtata permit to do tho work and instaiiatlarras Indicated.
I certify that-no work or irtstailation has commenced prior to the issuance of.a armit.
St.Wcle Couri• makes.no repre�entt��titrn that is granting. ermttwlu'atittto' 'the perenit holder'to build the stibject structure
witich is in conitctwith any appticabte+lomeOwners Assoc�atlon rules,bylaws c.atru covenants that may restrict or prohibit such
�Eructure.Please consult with yocir Home Owners Association and review your eel for any restrictions vibicih may appiy.
In consideration of the granting-of this requested permit,I do hereby agree th l.wi€i,in all respects,perform the work
in accordance with thit approved pians,the Florida Building Codes endSt.i.0 my Amendments..
The following building permit applications ate exempt froth undergoing a•full ncurrency'review;room sddietons,
accessory structures+swimming pools,fences,walls,signs,screen rooms and a uses to another non-resideatia.l use•
WARNING TO'OYItNW-Your f gure•to'>l+etard a Notice of CommIn Voter 0fE twa-.far
Impprovements to your-rperty,A:Notice of cornmencemant�m be retorded and posted on the jobsite.
.bare the•first�inspect on.If you inteh4to obtain financing,coil .It with lender or an attorney before
-com.mencing work or recordin ur Notice of Comm . .cement.-
S4natum-cif 0"ar/Aginti.lessee Signature- COntreCIVI Itanm.Holder
S ATE-QF.FWR1DA STATE'd.. iQ�i.
. f
ge-
The fo oitlg instrumetitwasecknow.ied d before ire. -The instrument%m acknaw+ledacd before,me
III�ay of- A 20��Y of b
y
r � sraQF`t7
(Marne of person ackrtostrledgti.g? (Nartfe of ; rsori at atdwledgtbt)
iSignature of Notarypu jig. we'of ttorwal? tSighaature f NoUry dbI1c-St2te o >:iorida'}
Personalty Known ,w OR Produced Identification , _ Personally own . o '
Type*f IdentificiTVpe of rde tiRca2t �,..ry,,.�.
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� Yna r`• 0 N RE2SSEI I 4`.°a `��, Notary Ptfbllc-State of Florida
Commission No. 11 i s r Commisslo No. comm al' Nov30 018
Notary •State of Florleaa " Y 2
ca" wYg My COMIh.EXAires NOV 30,201&' Commissio'n rC FF 179830
J ,4 OF
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Revised'07/15
7"` � goaded through National it 95 4V
Notary Assn,�l
REVIEWS FRONT ZONING SUPERV150ft PLANS: 'VEGETATiok sEATURTLE MANGR
COUNTER RE EW REVIEW REVIEW REVIEW- REVIEW REVIEW
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