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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
1 11
Date: I II l'lla,0otl
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Permit Number,
Build�ng Perrnit A�apl�cat�on
Alanning and peVeJapment Services
Building and Code Regulation 01vlsfon
2300 Virginia Avenue, Ford Pierce FL 3498,E
Phone: (772) 462-1553 fax: (772) 462-1578
Commercial Residential
PERMIT APPLICATION FOR: ELECTR I C,-/t
PROPOSED IMPROVEMENT LOCAT1,0N.•
Address: N. I-IFAf,F.gZ C�NAL r-Z
Property Tex ID #. - _ co .
Site Phan Name:
Project Name:
DETAILED DESCRIPTION' OFWORK,
LEN STNU, U►�D��2.G�outJ.D
GIFC 1
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4
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STRU- C9MQ D-�
4Y1G�_ 1CX 0CW
Lot Igo,
Block No.
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New Electrical Meter Second Electrical Meter (Affiddt required)
CONSTRUCTION INFORMATION;.
Additional work to be performed under this permit - check 611 that app#y:
Mechanical has Tan k � Cos Piping � ShUttorc
Electric
Plumbing
Total Sq. Ft of Construction*
Cost of Construct on: $
,Sprinklers
Generator
W6�
Win ows/DoorsAN ------- . 4
Pond
Roof pitch
Sq. Ft, of first Floor:
Utilities: Sewer Septic
Building Height:
If value of construction is 2500 or more., a RECORDEDNot-T of Commencement is required,
�.�y.
If value of HAVC is $7.,S00 or more., a RECORDED Notice of Commencement Is required'.