HomeMy WebLinkAboutBuilding PermitPermit Number: _______ _
Planning and Development SeNices
Building Permit Application ✓ Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fart Pierce FL 34982 ----------
Phone: (n2) 462-1553 Fax: {n2) 462-1578
PERMIT APPLICATION FOR:
PROPOSEOtMPROVEMENT.LOCATION:
Address: 2.11.\
Property Tax ID II:----'-~-'--·~--=-'-"--'-----------'-------------lotNo. ___ _
Site Plan Name: _______________________ _ Block No. __ _
Project Name: ______________________________ _
I DETAILED DESCRIPTION OF WORK: . . .
New Electrical Meter ____ Second Electrical Meter _____ _
I CONSTRUCTION INFORMATION:
A~onal work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors Pond
Electric _Plumbing _ Sprinklers Generator Roof ____ Pitch
Total Sq. Ft of Construction: ______ _ Sq. Ft. of First Floor: ________ _
Cost of Construction: $ l-j-OUi) • (JJ Utilities: _ Sewer _ Septic Building Height: ___ _
Name n
Address: 52,(A 0)r.Jli~
City: l:1>1Jf: Ptva, State:i:;c...
ZipCode: 3ift\SI Fax: ______ _
Phone No. M a.1,'a,,J ~ii ~'l3o *0131,
E-Mail:. ______________ _
Fill in fee simple T"ttle Holder on next page ( if different
from the OWner Hsted above)
CONTRACTOR:
Name:_tt·i{l'}~c-.t;_t~'.lf._ _______ _
~~;~:~~~~tn=~~tf~ ,Tut.
City: wt: Piu:ce. State: It.
ZipCode: ~I Fax:JJ'--¾3737
Phone No 11 l,,-Li(., ( • £4 l 4-I
E-Mail Poy{t.lAI! @,'-fWOO,r"n[Y\
State or County License C/lC I "l I i18 (p
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.