HomeMy WebLinkAboutjay koerber permitAll APPiICABLE 1NE�o Sb�I;ST �� Cot',JiPLETEi� FOR APPl1CAT10N To BE. ACCEPTED
Date: Permit Number:
Planning and Development5ervices
3uilding and Code Regulation Division Commercial �=✓S1d2�'t:��
230Q t/irginia;�venue, Fart Pierce FL 34982
Phone_ �772) �62-1553 Fax: (772) 462-1578 CBDG ;=unCfing
PERMIT "PPL',CATiOIV FOR:
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PROPOSED IMPROVEMENT LOCATION: _
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���I NW �1���-S C��,� �Li� P��� G� l�
Address: � .��Qq�
Property Tax 1D #: ��� '�-ZS' 00(3 _ P�00 -- 7Z i_ot No.
Site Plan Name: 81ock No.
Project 1`.lame:
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t�ETAILEI� DESCRIPTION iiF ��tJORI<:
W��CC Cf(gtitq�
fS tNG MET��
Neyv Eiectrica! Meter Second Electrical Meter (A�fiGavit requiracij
eolvsTRucTION IN�oRMATION:
Additional work to be performed under this permit —check all that apply:
1Vlechanicai _Gas Tank _Gas Piping _ Shutters _Windows/Doors ____ Pond
%� Electric _Plumbing _Sprinklers _Generator _Roof Pitch
� Tota4 Sq. Ft of Construction: _ __ Sa. Ft. of Frst Floor: i
Cost of Construction: $ %�( �,� Utilities: _Sewer _Septic Building Height:
OiN111ER%LESSEE; CON T FACTOR:
Name .�+'�Y �d��a�� __ Name: �rTuy�. �nl(��t^�Na1/i� _
Address: I LI�f NW �1NiFRS C K ��. Company:.�c��r:.RrE �i.�c:1�tCA � t..Gh}. 'f�f�t )fib, InJi.
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pit �1im C ��:���� �L- Address: ;;�� �� 5"TLi1c�� i�'1;Si �i�� f,��
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Zip Code:.�yQaO Fax: __ T City: (GAT �, L�ct�. Stater
Phone No. ��aZ—_ 3�/I ^ q ��s _ E- Zip Code: � �-la($� Fax: __
Mali: -�� I t. G MAIL. COM Phone No ?7-�- `��-'��"`���a
�� Fitl in fee simple ii#le Holder on next page (if different E-Mail A�c�'-�"� E�-��t>`. � i� � c��%i-�x31L� Ca!`1
frarr. il'�e owner listed abt3ve) I State or County License �C,CC<=%:.�C' 7�.
tfi value of construction is 250® or more, a RECORDED Notice of Cornmentement is required.
1f value ofi �iAVC is $7,5U4 or mare, a I?ECORDED Notice of Commencement 'ss requ'sred.