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Permit Number:
Date:
Swans Pam
Planning and Development Services
Building and Code Regulation DIvislon
2300 Virginia Avenue,Fait Pierce FL 3
Phone:1772)462-1553 Fait:(772)462-1578 Commercial
PERMAPPUCAMON FOR: TO Saiect from drapbox, click affow at the and of line
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Legal Description-
Praper V Tax ifs L\ � �! - �U L-o37 Lot No-
-
Site(Plan Name-, Bloch No.
Project Name:
Setbacks Front Rack: Right Side: Left Side:
[�D:ET:JAMED DESCRIF1TION OF WORK-.
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CONST'RUMOlN INFORDUAMON
Additionalwarl ec a a app 1f:
mvx Gas Tank Gas piping Shatters LJ Windows/Doors
0Elect& � 1 r ° j
�fa�n�l _
..e OSprinklers, �Generator L,�Roof
Total Sq.Ft of Construction: tFt,of First Floor:
Cost of Construction:S :J 2 5 �--� �9toli�ieSewer 0 Septic — Building Height: .-. _.
OWNERA SSEEn CONTRACTOR:
y Name: CIJ
Add ,l ~ tCia�v.
ompa
city: c� ~ wR State: Y� Address:
Zap Code: 0 - Fax:— . city: -1 El State:
Phone No. � Li Zip Code: L��l S-� G Y Fax: __
-V�a7ail: phone No. ®L( -- `a1
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Pram the PLOT listed Mb"MQ State or County License:
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