HomeMy WebLinkAboutpeak permitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
J ._
Building Permit Application
Planning and Development Services
Building and Cade Regulation Division
2300 Virginia Avenue, Fort Pierre FL 34982 /
Phone: (772) 462-1553 Fax: (772) 462-1S78 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description: e16, 2
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED t7ESCRIPT{ON OF WORK:.
Like Aw-- 3.5 *oh /Y Seokle 14e e-e4w?,
/ 4r,r -1Ai Jo Jk,- Ac) A e44
RUCTION INFORMATION:
a wor to e e orme un ert ispermit—c ec a appy:
V❑Gas Piping Shutters Q Windows/Doors
AC Gas Tank _
11 Electric 0 Plumbing ❑Sprinklers FiGenerator O Roaf
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Height:
Cost of Construction: $ ymp, Utilities: Sewer Septic Building
OWNERAESSEE: '
CONTRACTOR:
Name
Name:
Address: 7- Cce
Company: lm i1
City: 711 .81.0cL Stater
AddretssTu :510 Prfn f(G2
City: rU(-hi gtrc& State:%,
-6;L
Zip Code:3rfl Fax:
Phone No.
Zip Code: 4415 1 Fax: -71;-- LUO - 373-7
E-Mail: /✓%
PhoneNo.-rla-- 4101-41kI
Fill in fee simple Title Holder on next page ( if different
E-Mail: d
State or County Licen e: `AO I S I S I $ to
from the Owner listed above)
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.