HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Building Permit Application
Planning and Development Services
Building and Cade Regulation Division
2300 Virginia Avenue, Fort Piero FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Commercial Residential
CBDG Funding
PROPOSED IMPROVEMENT LOCATION:
Address:
C�
Property Tax 1D #E1b
Site Plan Naive*
CC Et%46EfiAr, LN
DETAILED DESCRIPTION OF WORK:
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IV Z9u1'4r 10�
P.dLm SIT
3y�90
Lot No.
Block No. ------ F ===Ev�
7-10 JF
6�4 x A9,1 c IJED Poec�l l4�YS
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION.
Additional work to be performed under this permit — check all that apply:
.Mechanical � has Tank � Gas Piping � Shutters Windows/Doors Pond
Electric M. Plumbing � Sprinklers Generator Roof Pitch
Total Sq. Ft of Construction: _
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Cost of Construction..0 p�
$
OWNER/LESSEE:
Name t--)T- t
Address.0.��C'
t1El-1 �c�ln!'So�
M
ce 6 A' 1:�o #ar,.,
Sq. Ft,. of First Floor:
Utilities:
Cot: 1�n Lrh CAT-'.1, M, State:.FC
Zip Code: 3y 9 70 Fax:
Phone No..�� Eal.
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Fill In fee simple Title Holder o next page Of different
from the Owner listed above)
_ Sewer � Septic Building Height:
CONTRACTOR:
Name:
Company: e�f 117 � ��f�1��S 14'L. �
Address: �-3LEOI $;t,0 5 �
City. r�dr) 14w ro,AJ^r .. State.- fffi"1-
Zip Code,. 3 Y Y,S Fax: IV4
Phone No
E-Maid 4N4CE40, 4z5,,A46,:a.��-cx�Ar63.eaM ,
State or County License
�f value f construction is 2500 or more., a RECORDED Notice of Commencement is req ui red.
i value i or more., a RECORDED Notice ofCommencement i required,