HomeMy WebLinkAboutBuilding Permit Application 07/07/2016 13:04 7724663737 BOYLEAC PAGE 01
ALL APPLICABLE INFO MUST BE com Law FOIL APPLICATION TO BE�
late: ��
XbIIla Permit Nurerlaer:
Building Permit Application
PtannkW and DevelpWwtservices
9uang and code Reguku"DARWoa
23W WVM[d Avenue,FM Pleme Fe 349V
Phone:(772)462-1553 -2578 Commercial — Residential
PERMIT APPLICATION FOR: To SeW from dropbox,dick anm at to end of line
PROPOSED IMPROVEMENT LOCATION:
Address: Q.� L� f 1 � � 44
�: - ..
Legal Description: 1�7Ult i 11A.. H'A'S 51k A � m,A- -
� � � .... •i-i.-yam
PropertyTax ID#: W No.�
Site Plan Name: B No.
Project Name: l
Setbacks Front Bads: Right Side,_Left Side:
DETAILED DESCRIPTION OF WORK:
C NA�„ Seer-a •I
3�tD n ' 1� r Le nMy, Al d s ys r a41A
C
, MDAd hea,� JtgA kso, (e- -30- A .ref- 1406W
CONST UCTION INFORMATION:
a workorm under s perm –r"
a ap y:
TTACGas Tank [].as piping _Shutters Windcwsex�rs
Electric Plumbing Sprinklers 11 Generators Raaf
Total Sq.Ft of Construction: Ft.of First Floor:
Cost of Construction:$ Utliitiessewer Septic Building Height, _,_„��"„•
OWNERAESSEE: CONTRACTOR:
Name nnniL Cjj1dS Name: 1�
Address:3 161 p tj�dlX.Vt5 t- • , Company: A `d' if! 1" G
City: IAU. State:I- Address; 7if;" 2
Zip Code: "v7, Fax. N LA City:- r�O f P t� C�_. ate: PL.-
Phone No. 121L dil 71p Code: ,' SG ,I Fax: A I' �
E-mail:
Fill in fee stmpl*Tide Holder on nett page(if different E-Mail: I��fe� a+t•nc.-t
from the owner listed above) State or ty i lcense:(`
if value of axuauctlon Is$2M or more,s RECORDED Nance of Commenaftwot2 b -
07/07/2016 13:04 7724663737 BOYLEAC PAGE 02
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATIOM.'
DESIGN EER: Not Applicable MORTGAa CQUIPAW.- _N&.Applicable
Name: Name:
Address: Address:
My; State' W. State:
zip: Phone'. Zip: MOM:
id SIMPLE MU HOMR: � _Not Applicable BONDING CMPMV-. Hot Applicable
11
Name: Name: --
Address: Address:
Zip:' Phone: A erste:
I cu*that no
work or hwailation has commenced prior m the Issuaoee of a perces.
wh9is Mmnflict Wi1f1WMpQMpS�� � �r�tlmt nj rr $Lldl
structure.Please Your Home Owners Assoclatian and reutew year �o strictions whid�rri9 aPP�
in consideration of the gmnft of this m4u%ted permlk,l do hereby agree that I edit in a€l erspetts,petforrn tim work
in aecor6noa with the approved pians,the Florida Bading Caries and St.UWs Cw2,AV Annndments.
The followins wo tg permit applkagons are exempt front underpoing a full axwwmAtv m4ew:room addltinw,
=essory suuctures,swimming pools,fences,waft sign%umen roams and mccmwV esu to another non-A lase
WARNM TO OMER:Yaw faittme to Record a Nam at CarnrnencaupM KM�! st In your pew twice for
Improvements to your property.A Notice of Commencement must be ceded and posted on the jobdW
before the first inspection.If you intend to obtain finandng,consult lender or an attorn� forr
eommencin work or record r Notice of Commencement
IL &AM1
SWh mre of Sigrmture of CoramttarAkuise iialda
STATE OF RMIDA STATE Or FMM
COUNTY OF,,,,^ COUNTY 9F T, S�,Lujue,
The f v tB instrument was admuwMdpd bcfare me The Bit*$nswimeat was admowlefted Mbm me
this r(i!`'dw ofZO b)r this--m&r of
iC�IAQL
ammom
(Ne of person ng) mo m of pftmn a� ) •
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(Slgreawre of Rot7171:11of ftortda j (Signawre of RuMry hHL-State of Flarida?
Persona Known OR Produced id tion Pel/Known
XOR Produced id ciebn
Type of WenunLl
Type of ld
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S C EE82WO
Commisdon No. I=• r81AtAla9s st EES
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20% s RES AqW 21.2fl91i
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07115i2014
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