HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: uIU/Zl Permit Number.
(��o LLL+�L
� Building Permit Application
Planning:W development Services
Building and Circle Baguio ten Division Commercial Residentialf'
23M Wrgin a Avenue Fort Pierte FL 34992
Phone: 17221462-1553 Fax. pRl 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address54S/)- a �Per Ise, i yl j
Property Tax to p'. ri fill-('n26 -ooc) Lot No
Site Plan Name._ Block No. L
Project Name.
r DETAILED DESCRIPTION OF WORK:
i Pi U s:) it
New Electrical Meter Second Electrical Meter (Affidavit requi red)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply,
_Mechanical _Gas Tank _Gas Piping _Shutters L Windows/Doors _Pond
_Sectrm _Plumbing _Sprinklers _Generator _Roof Pimh
Total SA. Ft of Construction: SA. FL of First Floor:
Cost of Construction:$ Utilities: _Sewer _Septic Brands claight
OWNER/LESSEE:
CONTRACTOR:
Name:I-Q L I, r-
Name cc,r� C2csJoli
Address: S4Gt'-/.ib-�T�.: It
�
Company:la�k'A I iLl�
City: Ii State
Address:72c.N"t Cn G�Pbn �:olY.J
City: �� %UC I e statel
Zip Code: 4Sli7 Fax:
Phone No. 71)_K]3-/3C.i
Zip Code:?SfA (NZ Z "Fax:
E-Mail:
Phone No t?-971 i3Z cJ�SNZ
Fill In Fee simple Title Holder con next page) if different
E-MaRGInctaiilaica
state or County. lice se 7H i6ti
from the owner listed aboval
If sawn of construction is 2500 or more, a RECORDED Phone of Cornmearprarrent is required.
If "I Be M HAVC is $7,500 or more, a RECORDED Nods of Commencement is neig ad.