HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
5�
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fart Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 452-1578 Commercial Residential_
PERMIT APPLICATION FOR:
PRjOPOSED IMPROVEMENT LOCATION:
Address: I f J( �Q X/ 1T
Legal Description: -,P (� /� iJ 47- 707 P 2 &--S e- 60 Z QY
Property Tax ID #: _ 3-37, 7_ 2 — 601, i - 0 6 40 Lot No.
_
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK-.
5 7- /I 1C, :E-:-;\ T- 6&
CONSTRUCT]ION INFORMATION.
Additional workme n
to e per oruer t is permit - check a that appy:
,Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
— Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ I (ZO D (J -Z-) Utilities: —Sewer —Septic Building Height:
CONTRACTOR:
Name:?'
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Company: na s h ez IN E?Q I fit ` iJ i 'r'
Name Cf
Address: H, a lk) . 14 4-C&
City: State:
Zip Code: Fax:
Phone No. '7Z Z -. '271 - , L,l 7
Address: z I
3 Z<n C-711 11 t
City: 6c k State: �J
Zip Code:'__ '_ �-! is (4) Fax:
Phone No 7272--409 -2p".2_
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail �L� LJ �[� S `L14Qh12Lj a
State or County License 4�__ WC_ i SS / i 0 242
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.