HomeMy WebLinkAboutBuilding PermitAll APP LKABLE I NFO M LI ST K COMPUTlW FOR APPUCATION TO BE ACCE PTED
Datu:
P(-.,m it N i.--mber-
k
Building Permit Application
Panning and Devekpwwnt Servxws
SUAS ng and Code RepuibUbn DTvisron Co rnme rc in I Residential
25100 VirWrlio AYLInot Fdr? Pierce F1 M0,1
Phony; (772) 462-1553 Fax: (777) 462-1578
PERMIT APPLICATION FOR=
PRivMPOSED IMPROVEMENT LO T10N:
AC!idre.5s: .'3 iA 0 G_S Al L. st.Ayl-1 i -,A o
Pr0pE rtyr Tax I U #_ _. )_ J 0 1 & 0 Z)O L 2- 000 A� Io# No.
Sit& Elan Name: flock No-
Proiev Na me:
DETAILED DESCRIPTION OF WORK, -
New E I�!ct rica I M pTer 5cLc c n d Electrical Meter
CC) NSTR U CTI ON I NFORM ATION:
Additlonak work to be perfvrmed -under this permit —cheek all that applw:
fvlecha n lea I _ Gas Tanis _bias Piping _ Sh u tters
-EIW r _ PlIvr0ing _ Sprinklers
Total 5q- Ft of Cgmtruction;
Cost of Construction: S `->j c?:_jD f.
OWiV ERf LESSEE:
Na
kJL
_ Gi� nera Mr
:Sq- Ft, of First Floor:
vitindowsfDoors _ Pond
Utllitle!'-S: . Sewer ._ Si�-ptic
h I CONTRACTOR;
Address: 8 `01SKX ,1 k-If' ,-CYa L-3
Clty, —Ei iqF 0_R e e Stato: fZ-4-
Zap Code• 34 El T_ E Pax:_
E-Mail:
Fill in tee sirnple Title Holder Qn next page ( if d I Ffere nt
fro m the C wner listed above}
Roof -- , Pitch
ftiiwirlg H ft:ht; _.
ame:.1 __ __rt_.j�.w La rc
Company-. L-v__
Address: -p s-? A V,
City - fA� ,►jr%, Stag: L 4
Zip Code: Y r"Lry Fax;
Phartie Nd n ? a 5 + p� 030)
State or County U tense
If tiraiu,e of mw!Ax ion 4 25M or mare, a RECORDW Notim of Camniaipement is Fequired.
If value of HAVC Is $F, -or rnoe*, a RECORDED Notice of Commencement is req uir -