HomeMy WebLinkAboutapplication1+1t Ai•(�r ItP-420111
! itt I+ J" "r• COMP1 Tr o FOP APPLICATION TO BE ACCEPTED
r�,o r _t�Permit rdumber:
B"Ailding Permit Application
PlfitleOju qml Prvrlt,prnrnt SPrvh rS
H,Nh!]no find (trrin llraulntlnn Nivislnr) C�Residential mmerrial
100 Vif uirniir Awrnur, / ort l'lrr(o l l 349$7
t•su7l,a 17/7) /t(;�-1�i�y3 F:�X: (7%2.j 462 9�i7$
CBDG Funding -
I'( F`4MIT APPI iCATION VOR:
I
{ PROP S(A) IfO PROVLMENT LOC-A-TIONI:
JtQuu—
I inl)erty lax Ih f1: �'l`_.I� -10' ' Lot No.
`,Itp Plan Name; Vi �%�,--��1 Block No.
1"10.Ipt:t Name:
t TAILED DESCRIPTION OF WORK.
New Electrical Meter _ Second Electrical Meter
CONS'iRUCTION INFORMATION:
/additional work to be performed under this permit- check all that apply:
?QVIochanical _ Gas Tank _ Gas Piping — Shutters
Electric — Plumbing _ Sprinklers
l'otai Sq. Ft of Construction: 13gd
Cost of Construction: $ _1_I-0-P0_
— Generator
(Affidavit required)
_ Windows/Doors Pond
Sq. Ft. of First Floor:
Roof Pitch
Utilities: __ Sewer __ Septic Building Height:
OWNER/LESSEE: I CONTRACTOR:
rdame � �_.t�Yl
NT i�1
Address:.
City SRI. _ State. i
Zip Codp: _ .4_Fax: —
Phone No, QaLo_ E-
Mail: —
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: '30h 1�
Company:
Address: J ID
City: M14�(1��-
Zip Code:aM-
Phone No
E-Mail aba
State or County Lice
11 Value of construction Is 2501i or more, a RECORDED Notice of Commencement is required.
It value of HAVC Is $7,SOO or more, a RECORDED Notice of Commencement is required.
State: FL
:ax:
n212-1