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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE EOMPLETED.FOR APPLICATION.-TO'BE ACCEPTED �� ������- Date: l 0"�-��ZI Permit Number:•� — Building Permit Application Planning.and Deve(opment'Services, Bd#ding.andcode>iegulation`Divsion Co_ mmercia'I Residential 20V . 982A , , 3 Phone:(772)462=1553 Fag:(772)462_457$. CB'DG Fu'ndirlg • PERMIT APPLICAT16N FOR: PROP =)MtE�©1/E !lPVT LacAT F 8 � Address. Wo S t eogyy b,r, '1,-Fose,o iiecfclk L Lf 5 ' Property'Tax ll7#: �1- 6 ,Z -- 00 t Lot No. • Site Plan Name:: __ Block N* Project Name: 4(4r,4C,Icrj (L-6,0 - DET IEEQ DESCRIPTION yaF WV K,� , .x�.. r, _..� m. • .fit art°c �uc� New Electrical Meter, I Second Electrical:Meter (Affidavit required) , CCNSTRUCTItNIlFC} MT�C}N Additional work to be performed under this permit—check-all that apply:: Mechanical _Gas Tank lGas Piping _Shutters _Windows/poors _Pond Electric _Plumbing Sprinklers _Generator —Roof Pitch Total Sq Ft of Construction:.. ! Sq.,Ft.of Fi-st,Floor: i t Cost;ofConstruction:$ r Utilities _Sewer _:Septic Building Height: . Q�lllNfRflESSC � AP" g Name Name: 2 ✓,' L.; b� 'Q Address- R 6 0 Q r:;g uy% Company:. City- 5-evk$R V1 B u CV1 - State: F& Address- I S 6 D A k 0& W Zi Code:: 3 to ri ..s 9. Fax' Ci �,U s 4R&Lm 1�,e o c State: " l p; tys . Phone No." E'= ZEp Code: 7 3 4 Fax:. Mail.; Phone NoS Fill in fee simple Title.Holder,on next page(if different. E-Mail q _e. . C d mt r id.i'r o�i 15 t. �► a-� °a from the Owner listed above) State or County License: C.6C I.b.1 If value of construction is 1500 or more,a RECORQEMNotice of Commencement is required.. If value of HAVC is.$7,500 or more;a RECORDED Notice df'Comm"encement is required: