HomeMy WebLinkAboutBUILDING PERMIT BALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Late: Permit Number:
Building Permit App
Plan n fng a n d Developmen t .services
Building and Cade Regulation Division
2300 Vfrg[nia Avenue, Fart Fierce FL 34982
Phone: ( 4 -1 Fax: ) 462-1578 Commercial Residential
PERMIT APPLI CATION FOR: To Select fr r box, CliCk arrow at the end of line
PROPOSED IMPROVEMENT LOCATION :
4
Address:
Leal Description: Vt2ccd 15 ,R _
Property Tax l I #: 3,-3,2 Lot N o.
Site Plan Jame: Block No.
Project Name :
Setbacks Front Back: Right ht Side : Left Side:
DETAILED ESC IPTI N OF WORK.-
CONSTRUCTION INFORMATIO :
Additional work to a er rrne under this permit — check apply:'
C H Gas Tank Gas Piping In Shutters Windows/Doors
Electric __ Plumbing _] Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
. ),50 Utilities: Sewer e tic uildin f�--i�ei ht:
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WNERAES EE : CONTRACTOR:
Name 0 Vy"), Name: o vt
Addr Ook.eekc, 1 Compan
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City: ON Mate: Address,
Zip Cede: Fax: it � " LU State:
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Phone No. � �� � � `� -- _ _ Zip Code: _ Fax.
E Mail . Phone No. 7 '
Fill .n e simple Title vI rn n �� � if different E-Mail: 2
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h State r Court License: C9
t Owner listed a +
If value of construction is 00 or more, a RECORDED Notice of Commencement is required.