HomeMy WebLinkAboutBuilding permit appAll APP iC L )N O U57 � OMPLETEV FOR APPLICAitON TO BE AC:CEMEO
J:ate: _ ,W Permit Number:
APV
Building; Permit Application
Residential
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Phone: (772) 462. 1553 Fax- (772)462-'S78
PERMI (Jt PPLICATION F'(�R �
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Property Tax lu W Z - % " bo 3 ;2-= O oc) 3 --- -- - Lat No,
Sitt• Plan Name: block No.
f ro)ect Name: �--.._--..----._.._.._...--�--------------------
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h1e•a flertrical Meter-_____ Pcond E:ecrrcal Meter _.
AYdItyd.IjwojktobepeTTormed underthispermit "• che� ail that apply:
echanical Gas Tank Gas Piping _ Shutters Windows/Doors
Llecttir. _Plumbing _%innkleri _ Gerwiator _. Roof
t owl Sy. I't of C0I Str ut t - _ Sq Ft. of r- rst i lour:
ostofConstructio 5, _Yo�! .-- � C Itrfitirs evict _'septic SwidingHeight:
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Fill in fee simple Title Holder on next page (if ditfcrent ; +; Mail f ( s
from the Ovmer listed above) SJ3re Or County 0, e
if value of eanstruction is 2505 or more, i Rf;CORU£.[7 Notice of Commencement Is required
Jf value of HAVC fs $7,500 or more, a RKORUED Notice of Conirnencement is required.
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'`�^n4tvlhlca TO OWNER; Yaw Kwav ;., Recoid a Noticp : t:: fn r;�em"llt may resul in paying twice For
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