HomeMy WebLinkAboutLloyd Permit App for AC pg 1 001ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: � (�S��a Permit Number:
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) 462-1578 Commercial _ Residential
I PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III
Address: -S J <
Legal Description:
Property Tax ID #: ! "f 2JO — ,5D , - 001 `7- 000 -0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION: INFORMATION:
Ad itl a worktobeDerformed underd
this permit -check
all apply:
HVAC GasTank
❑Gas Piping
_Shutters
❑windows/Doors
Electric 0 Plumbing
Sprinklers
Generator
Roof
Total Sq. Ft of Construction:
Ft. of First Floor:
r�'
`[ Cost of Construction: $ qo 0.OQ
Utilities Sewer E]Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name -r114+ Ut)h In JZ
Name: 6
Addr/eess:3,Zgq VQr�(
n
Company: ll& (:t(liklf6fe £ yponq
All:
City:(bilt hev(t- State:
Zip Code: 3 4111 Fax:
Phone No. 113-- 514- 4 (P I s
Address:-FFTLLfYI (C2 I PP
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City: rb(-& f t efcR,, State:_R,
Zip Code: S " 5 ! Fax: Z1 e2- 4&(p -373`t
Phone No. -"A- �W-414-1
E-Mail:
Fill in fee simple Title Holder on next page t if different
from the Owner listed above)
E-Mail: V((9aL#I VA60. ca (n
State or County License: CA-0,181 x f Z
If value of construction is $Z500 or more, a RECORDED Notice of Commencement is required.