Loading...
HomeMy WebLinkAboutLYMAN 1All APPLICABLE 1N�D �IIIL�ST BE G�1111PlETED FAR APPlICAiIDN T� SE AC�ERTEI� Qate� �� t �--� � .� � k � • L '� J 7 yf� � �+ a r L ; � � � �� i >. `� �`����� Building Permit Application Planning ❑nd Development 5ervrc�s Suild�ng and Cody Regulation Diuisian �3pn Virginia Rvenue, For#' Arerce FL 3�982 Phone: 4772) 462-�5�� Fax: �77Z} 462-�57� Commercial Res�der�tia� V PERMIT APPLICATION FOR: ELECTRICf1L PROPOSED IMPROVEMENT LOCATION: Address: Ib85'S` �iENR`I�`5 �D . Property Tax ID #: �-- _�aai- 5o i-�o�.�000 - ► got �o. DETAILED DESCRIPTION OF WORK: �s-r�,L� C�r����n �ro UN —� G�:LtN� �a.1d�SK �Ml��IG `-!'2A�ISFF�4��TCFt P�N,D C�I'� �T02 T�(STI�tL M�T� � c,�N �v � c��a�t �� � � 5�s-r� New Electrical Meter Second Electrical Meter (Affidavit required) CONSTRUCTION INFORMATION: Addi�iona! work to be performed ��dcr this permit - �h�ck a!I that apply: �M�chanical � Gas Task T Gas Piping � Shut�e�-s Ele�'�ric _ Plumbing Tvta! Sq, Ft of Cvnstructiv�: Cosh of �Qnstr�ctFor�: $ ------ J' ��,�'�] .fib Sprinicler� lltlindows/Dvvr� Block No. . Tt�ST¢iLL Pond Generator Raof Pitch Sq. Ft, of First �Iva�: Utilities: ,� Sewer � Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name F(2d�ICIciL �NMOcN � Name: � E, Address: 1(�$SS- l�eYlv�S �Ci. Company: Na-4u� Ct city: V=k. Aeres� state: � � Address: 1A1D-1w� iciWQU Zip Code: c�H� Fax: City: �', P�P�esv state:) Phone No. Y1''1a-y (off- 15'13 zip�ode: 3'-Igga-- Fax: E-Mail: Phone No �►7a-+Cat- 83a� Fill in fee simple TRIe Holder on next page (if different E-Mail �,(�YY1et IY1L1i-�.�e�.dQO � � • C�9'Yl from the Owner listed above) ---- State o Cr ounty Eicense �C.1���� � (0�� -- �