HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dale: Permit Number:
LLLL3,OL�"
"7rE1J�//Ff Building Permit Application
readig oM Development Services
Building and code Regulation Woman Commercial ResidenElal„L
23W Wriinm Avenue, Can PieM FL 30983
Phone: p721 462 1553 Fax: (772)062-1S78
PERMIT APPLICATION FOR
PROPOSED IMPROVEMENT LOCATIOT
Address'. E4-nl D V1e 1-)L_
Pmpeny TaxlDC. LmNo.
Site Plan Name: Block No.
Project Name.
miDETAILED DESCRIPTION OF WORKZ p
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New Electrical Meter Second Electrical Meter (Affidavit mqulredl
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- Check all that apply:
_Mechanical _Gas Tank —Stripping _shutters <241yVindows/Ooars _Pond
_Electric _Plumbing _sprinklers _Generator _Roof Pitch
Total Si It of Construction: Sq. Ft. of First Floor:
Cost of Construction $ I>fiQ Utilities: _Sewer _Septic Building Height'.
OWNER/LESSEE
CONTRACTOR:
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Name:
Address 71'b'� cter
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City: T7'A ohgg�
Zip Code: Fax:
Phone No. I 7� Tot -
state:
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City P7 % v i (-,ice State:
Zip Code. Fax:
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Incentive Owner listed above)
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state or County Uceise)R46
nwasse or construcason is Lima "MGM, a MA -Li Notice ortommaxincement is rtrtner.
BurhW aNAVC Is $7.500 or MOM, a RECORDED Notice of Commencement Is required.