HomeMy WebLinkAboutBuilding permit appAID APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: F) 118 lolba k
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Permit Number:
Building Permit Application
Planning and Develapment Services
Building and Cede Regulation Division
2300 Virginia Avenue, Fart Pierce FL 34952
Phone: (772) 452-1553 Fax; (772) 462-157$
PERMIT APPLICATION FOR:
Commercial Residential Y
Eo- LECTRIC \L
PROPOSED IMPROVEMENT LOCATION:
Address:�1�iE2C� FL
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Property Tax ID top
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Site Plan Name:
Z
Lot Na. 14
Fwal
k�l Z. �STL�'i� S Block No. 5S
Project Name:
DETAILED DESCRIPTION OF WORK:........... .. .. .
New Electrical Meter Second Electrical Meter (Affidavit required)
CONsffirRUCTION INFORMATION:
... .... . ...... .
Additional work to be performed
Mechanical
Electric
Gas Tank
`Plumbing
Total Sq. Ft of Construction:
Cost of Construction:
OWNER/LESSEE.'
ender this permit — check all that apply:
_Gas Piping � Shutters
. Sprinklers
1 Windows/doors Pond
Generator Rovf flitch
cl* Ft. of First Floor:
ti 11ti e s: Sewer Septic Building Height:
Name 11E- .Clmc
Address:- L21C)�akc--Q, bf-
City:'A►�Y'C� _ State:
zip Code: Fax:
Phone No.
E-Mail:
Fill in fee simple Tithe Helder on next page if different
from the Owner listed above)
CONTRACTOR:
Name: o1.�(YleS f I(r
Company: "WrwAa,
Address: 10kO \r:i Ml'tAuyl,�
pity:
Zip Code: Fax: _
Phone No
E-Mail
State or County license
If value of construction is 2500 or more, a RECORDED oti f Commencement is required.
If value of HAVC is $7.,500 or more., a RECORDED Notice of Commencement is required.
State: R .
i 40 t7
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