HomeMy WebLinkAboutBuilding Permit Application �1
ALL APPLIC. LE INFO MUST BE COMPLE' u r e[IR APPLIGATION TO BE ACCEPTED
Data: ;I Permit Number:
EiyU g Permit Application
Planning any Development Services
Building and ode Aegulation Division
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2300 Virglnl Avenue, fait Pierce FL 34982
Phone: (77 462-1553 Fax: (772)462 _'>7831 Commerdai Residential
PERMIT A PLICATION FOR: To Seieckfrom dropbox, click arrow at the end of line
Address: S• Cf0•v
Legal Descrip on:
Property Tax it: �7S3y- �U 1- Ot� ,` ova-`f L tr!o
Site Plan Na 8i ck Nc' -
Project Name
Setbacks F'' nt - Back: a.1. f',Rlght Side: Left side:
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E)(C4C " ce ^
I Iona w to b rformed un er $, t t—check all apply:
�HVAC Gas Tank �s'Plping _Shutters ❑Windows/0 ors
Electric ® Plumbing [2! li'nklers Generator Roof
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Total Sq, Ft of onstruction: '��t S .Ft,of First Floor:
Cost of Constr ctfon: 5 ' �2�' t 1j', Ut11(ties: Sewer Septic Building Height:._
Name C 6 v�-t.p E 1' Name: Ps! � G N
AddrI'.
. 0t o-v, Sb' Company: MQW004 t(y i
City: RC9� r3aip L Address: Of QQ ;
Zip C Fax: f' City: �d 5�— 1,�Ji2 tate �—
Phon i Zip Code:�gljd- Fax:�gl? W *31 E-M Phone No. N6 J—li li
Fill in fee limp a Title Holder on next page (If ' Trent E-Mall:
from the Own r listed above) 1 State Or County License:
If value of const uction is$2500 or more,a RECORDq[I;Flotice of Commencement is required. r
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f7E51ANt it NEEFt: dtif, PllditTCtPGE C$MPANV� Not Appil ble
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FEE 81MPLE TLE'NOL¢Efl. _ tdot A Elie 90ND1Nt3 COMPANY: _Not Appiic le
Name; Name:
Address r�_ AddrQtst
city: _ city:
Zip: I Phone: d l Blpt Phone; i
i certify t}satn k or installaNan has.wanmunpp c pr��r to the lssawnce at•f.pefMh.
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TMWlowingb I[dingpertnitappbellijonsare ! munde{giftsfwf4lcuirenty review;room aciOtlons,
accessory strut r d'swlminling Poah,'iwnttrt ,scrBen rooms and acrossary uses in mother non-residential use 1 ,l
WARNING T .OW ERtfyour failure to(itch I : latke cf Commenexrnatrt marl result in your paying twke f r i
im royemen to your-property.A Notice a lnMon ce ent must lye moome4and posted on the Job to 1 1
be P the N in on,Ii{rou ntertd a�t '►n tVulnt coM4 wlt" lender or an attomey before I;!'•
com enetn in a Notic ° t " en ent
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