HomeMy WebLinkAboutBuilding PermitALL APPLICABLE INFO MUST BE COMPLETED FOR APPUCATION To BE ACCEPTED
Date: 2 3{ ZD Permit Number:
Building Permit Application
Planning and Development Services
/
Stltilding and Code Regulation Division
2300 Virginia Avenue, Fort Pierre FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential _
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address:�l'^II_,,rA���
Legal Description: Pyt - ull l`rL 4 el V- 3.1 Lot- 5 1(P 5 1, /
Property Tax ID #9: O 1 " 0 112 ` 0 0 0- q Lot No.
Block No.
Site Plan Name:
Name:
Project
Setbacks Front Back: Right'Side: Left Side:
DETAILED DESCRIPTION OF WORK:
(� `=pY LI � uPIyAx 3 TY, l(.P sew s� lid
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A1C sIsfun CAI t0"
CONSTRUCTION INFORMATION:
I I a wor to e[j orme un ert isperm�t-c ec a appy:
❑Gas Shutters Windows/Doors
HVAC L I Gas Tank Piping n_
00ectric 0 Plumbing Sprinklers 1J Generator Roof
Total Sq_ Ft of Construction:. _ Sq- Ft. of First Floor:
USewer 0 Building Height:
Cost of Construction: $ o00 .6D Utilities: Septic
OWNERAESSEE
CONTRACTOR:
Name Q YYIi P
Name:
Company:
Address: �M I I�JeL Y110Iia
Address:5{O Pr -FA I ik.0-
PIPfcf State:
City: VII
ZipCode: 3IPSI Fax:
City: f�171QfGPi State:
Phone No. t7 % ^L12' (!GI.1'$.��
Zip Code: S 4415 1 Fax--73a-- 4&1�
E-Mail:
PhoneNo.-TIA-(�l-l� l
Fill in fee simple Tide Holder on next page (if different
E-Mail- —
lr; 181-31 (P
from the owner listed above)
State or County Licene:
'
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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M.YMMIC • State a Florida
`n •° Commission M GG 484701
'�a ��. My Comm. Expires Aug 21, 2024
National Notary
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