HomeMy WebLinkAboutBuilding PermitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: O(o`il l 2 1 Permit Number.
Building Permit Application
Planning and Ocvelopmerrt5ervicm
SuOding and Cade Regulation DAAWM
2300 Yhgkda AwnaG Fart Merm FL 34MZ
Phone: (772) 462-1553 Fax: (7T1) 462-1578 Commercial Resider ial iC
PERMIT APPLICATION FOR: To Select from dropbox, dick arrow at the end of line
Legal Description:
PropertyTaxID#-. 9,936 331 -0006— 0010-4 Lot No.
Site Plan Name: Block No.
Project Name,
Setbacks Fmnt Bads RightSide: Left Side:
Total Sq. Ft of Construction:
Sq. Pt. of First Floor.7o
Utilities [] Sewer [,]Septic Building Heq ft _
Address: LA J- I S _ cu ; i7'�
city. t V -�� State. _TJL
Zip Code: Fax:
Phone No.
FiB in fee Smpte Title Holder an next page (ff different
from the owner Road above)
Compam/: V'W-A c- �
Address: 153-3 A 'P4�oo--�Q•.t �va-�
City: State: X-L
Tip Code:'3 `ACASO Fax:
Phone No. �a2 aCt3 V�k
E-Mail:�-
State or County License: C AC \ I':)- R S-t.*)