HomeMy WebLinkAboutBuilding permit app pg 1All APPUCAILE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: JI '2-1 j 2: \ Permit Number: _______ _
Building Permit Application
Planning and Development Services / Residential Building and Code Regulation Division Commercial ____ _ -----
2300 Virginia Avenue, Fort Pietr:e Fl. 34982
Phone: (772) 462-1553 Fax: (n2) 462-1578
•
PERMITAPPLICATIONFOR: l\\e CJnA•.-a:-Oltk
PROPOSED IMPROVEMENT LOCATION:
Address: 1 aoi 'P(L,jfic Alt. Cork :v,uce,
PropertyTaxlD#: l~Ol--(pl3A0['{5-000-;J...,
Site Plan Name:
, l AK®oa.{ P4't
Lot No. ___ _
Block No. ---------------------------
Project Name: ______________________________ _
I OETAltEO~ESCRIPTION OFWORK: . uw Ji UkR,: j'iisfu!l nw lillOOX. ,3]on, l(p SGi;g.
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 Pond
Electric _Plumbing _ Sprinklers Generator Roof Pitch ----
Sq. Ft. of First Floor: ________ _ Total Sq. Ft of Construction: c--------
Cost of Construction: s 4& oO. oo Utilities: _ Sewer _ Septic Building Height: ___ _
OWNER/LESSfE:
Name.-0....._.""A--.=----i-".:..:..:~---,.--.,,--,.----=--
Address::.Jll~:.Jjooi~~£..,,___~~~5~,n~a/\~
City: j,04:,: Pru:::ce... State:~
Zip Code: 3i4!,<; l Fax:~------
Phone No.~ SCt • 11-1-1 4 VS~,-.
E-Mail:. ______________ _
Fill in fee simple Title Holder on next page ( if different
from the Owner fisted above)
CONTRACTOR:
Name::...H~'WlL-¼-~i¥fiL--..,.......---,--~-
~;~7:~a1~~Q-~~µt.
City: 11)(1-; l>iUlt.. State: It.
Zip Code: ~I Fax: 1].;i-4'«r 37 37
PhoneNo111,::':lui• 1-4141
E-Mail YJoyt,.(Af!. t,, '-{WOO· ff}(Y\
State or County License CACljf'll~ (,
If value of construction is 2500 or mare, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Convnencement is required.