HomeMy WebLinkAboutPermit App Pg 1All APA"BLE I N FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Rc� ral i( N um be. r:
Building Permit Application
Oa� and Wwkwnves
&wrap and Code Repufwkw D rrrsfan
2300 WrL inky Avenue: Fit Prenec FX,34982
Phone= (772) 462-1556 Fax_ (772) 462-1572 Corn m a rcla I Residential
PERMITTYPE,
PROPOSED IMPROVE NT LOCATION:
-
Property Tam. ID U; f - Lok. N4) -
Site Plan Mame: Block No -
Project Name: K a rl Ci ' V "..�- :L �� �¢ � C Com: -,- vim. ��,, � r� .A- A
DETAILED DE I"ON OF WORK -
14%
CONSTRUCTION INFORMATION:
Additional work to be oerf rrwd under this p-rmit - eheck all that aooly;
mechanical _ 6:6 Tank _ C)Piping _ Shutters — Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Gurw' r�ftr _ Roof P,tch
Towl Sq. Ft of nstrijobon!
C-st of Construction:
OWNER/LESSEE -
Sq- ft- of Fi rst FlDor:
utilities- _ SeWCT a 5, ptic 6uildi ng H6-ighk_
Address: 2-6-Z3 _
.City: V-•$- f •I 'e ( S#ate �l
zip c0°de: f '-f=
ph,orne
CONTRACTOR:
Hahn -p:
Cry r"y- a
Address:
TV --
Tsp
Code: Fags=
E -Mail: 7S q { �� � �C %ML) EMCN&WOL4 rl Phone Flo
'Fill in fey simply Ti to Holder an pap 9 diff nt tMail
from the Owner Fisted abmm) State or Cnnnty License
kF whn pf 4Qvw#nLKt1on is 525DD or mom,;) RECORDED Nokias of Commr.nr7.mr;nt b TwOrw-
Evaluv & FIVAC ic S7,5DD or mbre, a RECORDED Naticc of Commencement i requble&
Statel.