HomeMy WebLinkAboutScanAll APPLICABLE I NFO M U ST 9 E COO" P LETE 11 FO R APPLICATIG N To BE ACCE PTE D
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Building Permit Application
PfUnrIkT 13nCf iii dopment Sunfices
60&ng 13nd f0de R-guk?6on ail Tian Commercial Re! ddentia l_/
23W Virginia Avenaw, Fort PjerCk- -FL 3.qW
Phone: �7 72) 462-15 3 Fax: 07721 4F,2-lS?;K
PFRMrF APPLICATION FOR:
P RIO P OSED I N1 PROVEN -1 E HT L QCATI 0 N:
aF(_, 3qgS-p,
Property Tax ID M;
Sfte Man Plame:
Project N�rppc:
LTAILED DESCR t.PTI QNr OF WORK,
IM No —
Block No-
New El ecV1,-a! M P- e, E e•-ricai Fo1ctar
CONSTRUCTION INFORM.ATION-
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Additional work to be. P�' Ormed undCLr this perms –check -all that apply;
�eth nical — Ga,,, Tank — Gas Piping — Shutters Window_5,/fors
Pond
Electric P lu ITS bing-rs
SprinkIL Gr-nerator Roof Pitch
fetal Sq. Ft of Construction SQ. Ft. of Fiat rlour:_
Cast ot -Construction:
Utrities: Sciver 5eptic f3ui IdIng HM
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FOWNER/LESSEE: r-ONTRAC70R.
N arn s
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Is Orn Pa nyZar-cl
City:
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Phone fj0L 72 r 0_ 210 CDde: 3
E -Ma ill-, Phone
Fill in fee simple Trtle Holder on next page ( it diffezr.nt E-foai __!;'gro
Pr
frarn the Owner listed above] State or CounLy Lic'
If value.Fwnstrur-ticmis25Oocwmtam, ;aRECORDEIDNV&eofcommenoBmenk—Fri requk-ed-
If value of HAVC 19 $.7,500 or mord, R RECORDED Neytice Gf Commencement is roquir-&d.