HomeMy WebLinkAboutBuilding Permit ApplicationDate: ____________________ Permit Number: _____________________
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial ________ Residential ________
PERMIT APPLICATION FOR:
PROPOSED I PROVEMENT LOCATION:
Address: __________________________________________________________________________________________
Legal Description: ___________________________________________________________________________________
__________________________________________________________________________________________________
Property Tax ID #: _________________________________________________________________ Lot No.__________
Site Plan Name: __________________________________________________________________ Block No. _______
Project Name: ______________________________________________________________________________________
Setbacks Front__________ Back: _________ Right Side: _________ Left Side: ________
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit – check all that apply:
__ HVAC __ Gas Tank __ Gas Piping __ Shutters ___ Windows/Doors
__ Electric __ Plumbing __ Sprinklers __ Generator ___ Roof
Total Sq. Ft of Construction: ___________________ Sq. Ft. of First Floor: _________________________
Cost of Construction: $ _____________________ Utilities: __ Sewer __ Septic Building Height: __________
OWNER/LESSEE:CONTRACTOR:
Name__________________________________________
Address:________________________________________
City: _________________________________ State: ___
Zip Code: ______________ Fax:____________________
Phone No._______________________________________
E-Mail:_________________________________________
Name: __________________________________________
Company: _______________________________________
Address: ________________________________________
City: ______________________________ State:____
Zip Code: ________________ Fax: __________________
Phone No. _______________________________________
E-Mail: __________________________________________
State or County License: ____________________________