HomeMy WebLinkAboutBuilding Permit·· All APPLICABLE INFO MUST BE COMPLETm FOR APPLICATION TO BE ACCEPTED
Date: ?-J.,1,-,J.I
'
Permit Number: _______ _
Building Permit Application
Planning and Development Sentices
Commercial / Residential Building and Code Regulation Division -----------
2300 Virginia Avenue, Fort Pierre FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: A <! e1ii .... An -Oltk •
PROPOSED IMPROVEMENT LOCATION: V
.
3</9S'l
Property Tax ID#: ________________________ _
Site Plan Name: ________________________ _
Lot No. ___ _
Block No. __ _
Project Name: ________________________________ _
I DETAILED DESCRIPTION Of WORK:
New Electrical Meter ____ Second Electrical Meter _____ _
I CONSTRUCTION INFORMATION:
A~nal work to be performed under this permit-check all that apply:
_Mechanical _ Gas Tank _Gas Piping _Shutters _ Windows/Doors
Roof
Pond
Electric _Plumbing _ Sprinklers Generator ____ Pitch
Total Sq. Ft of Construction: ______ _ Sq. Ft. of First Floor: _________ _
Cost of Construction: $_~'1~/)~Q~t)~. ___ _ Utilities: _ Sewer _ Septic Building Height: ___ _
OWNER/LESSEE:
Name.___,~ ..... -=-<--==>,._..,~...L..<.uz.-'-"'--P<'----
Address: 7'lt,.,1 S..._ } /!If-. n Q
City: 6 J P, t. 1-e E State: a..
Zip Code: J qq{:" I Fax: _______ _
Phone No. 7 7 :J. -'I 73 -fJ "71/ .3
E-Mail: ______________ _
FOi in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name:
~:;r::;:ra1~-tn=11 ~ft~ .ru
City: 6it Piu:ce.. State: It,
Zip Code: ~I Fax: 772,-tf,r..-37 37
Phone No11l:-::%1• £114 !
E-Mail YJoyi,.~ l,\.(4<b@~PJJQ'I
State or County license CACI <JI ~I 3 (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~ is required.