HomeMy WebLinkAboutBuilding permit app.All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Oates . l I I}j I 'LOZI Permit Number
—�T
If � l �� Building Permit Application
planningaM Dayedo mene5mkes
annual and code banana Claude" Commercial Residential .
23W Virginia Avenue, Port Pierce R 34982
Phone: l)RI 462-1553 Fax: (232) 4621578
PERMIT APPLICATION FOR:0 araq C. � w �r olnr ylne
PROPOSED IMPROVEMENT LOCATIO
Address: 119 olitickeif M L n f 4
Property TaxlD11 IV.1U i09 Lot No. E
Site Plan Name: Black al
DETALMDESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters ,_a Windows/Door _Pond
_Electric _Plumbing _Sprinklers _Generator _Roof _Pitch
Total SA. Ft of Construction: SR. Ft of First Floor:
Cost of Construction:$ I4Ql Utilities: _Sewer _Septic Budding Height'.
OWNER/LESSEE:
CONTRACTOR:
NamelYl0.rK Pran c ode
Name: I .. R
Address: 112 niaDD,n rNYcPW rL
COmpaoy: *now
/�
city: Tom. c_ quell State: fL
Zipcode:?Aqu4 Fax:
Phone No. C2 An 1 —]jL
_A-Tcgir
Address: -7[ di G I .A
City: n--L S1,2CP Stater
Zip Code:ra+145T 'Fax:
Phone No (?ill !3 R- 54 1
E-Mall:
Pit In fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mall
State or County.L ne7 'ie
If value or combustion Is exu l or more, a eewnueu rerre m vmnn..nuv,mm n Pry........
H value of HAVE Is $3,500 or more, a RECORDED Notice of Commencement Is required.