HomeMy WebLinkAboutBUILDING PERMIT APPLICAATIONAl I APPLICABLE WD MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date. 9 ! - 1 Permit Number:
Building Permit Application
Planning and Of- veivpment Services
auddOgand Code ReguhitonDivision Commercial Residential `
7300 Virginia Avenue, Fart Pierce FL .34982
Phone: (772}1462-1553 Fax. (772) 4 62 -1578 CBDG Funding
PERMIT APPLICATION FOR
PROPOSED IIMPRO EMENT LOCATI ON:
Add re55; _
Property Tax I #: 610 9
Site Plan Name:
Project Name: —_Karf
New Electrical Meter
Second Electrical Meter
CONSTI iJCTkOly INFORMATIOW
_ (Affidavit required)
Lot No -
Block No. —
Additional work to be performed under this permit —check all that apply:
__Mechanical _ Gas Tank _ Gas Piping _ Shutters Windows/Doors _ Pond
Electric ! Plum birng _ Sprinklers
Total Sq, Ft of Construction;
Generator Roof Pitch
Sq. Fx- of First Floor;
Cost of Construction: $ utilities
O NER/LtSSEE:.._
Name —
Address: ftrUrI
City- C state:
Zip Code' I Fax:
Phone No. E-
mail,
Fill in fee 5irnple Title Holder on next page (if different
from the Owner listed above)
Sewer Septic Building Height:
CONTRACTOR:
Name;
Cornpany; I Vl yC
Address:
City. ` State:
Zip Code, Fax:
Phone No 0
E-Mail wlyu
State or County License
If value of Construction is 2500 or more, a RECORDED Notice of Cnmmenr.ement is required.
if value of HAVC is $7,500 or more, a RECORDED Notice cf Commencement is required.