HomeMy WebLinkAboutBUILDING PERMIT APPLICATION PAGE 10
All APPi.ICABL F INFO MUST BE COMPLETIED FOR APPLICATION TO BE ACCEPTED
Date: ��_ d : AIL-.
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P I um er:
E;ui'ld'ing Permit A[)Dlicati"on
pfanning ano Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierre FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
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PERMIT APPLICATION FOR:
PROPO
Address,
Commercial Residen
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SED IMPROVEMENT LOCATIONN
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Property Tax ID #If
Site Plan Name:
Project Name.
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DETA1LED
bESCRIPTION. OF, WORK:
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New Electrical Meter Second Electrical Meter (Affidavit required)
CON$TRUCTION INFORMATION,
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Additional work to be performed ender this permit —chick ail that apply:
Mechanical � Gas Tank � Gas Piping � Shutters
_._. Electric Plumbing ,� Sprinklers Generator
Total Sq, Ft of Construction:
Cost of Constructj. �.
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WNER/LE
SEE #II , r
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Lot No.
Block No.
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Windows/Doors Pond
Roof Pitch
Sq. Ft. of First FI re
Utilities: Sewer Septic Building HeIghtL
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Name...4USAA,
address: ' C% vJAA L
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City:ElL., �.y' ' State:
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Zip Cade: r� � �L Fax
phone No. 4)-L-
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Fail in fee simple Title Holder on next page'( If different
from the Owner listed above)
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ONTRACTOR,
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Names �.. l..
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Company:
Address:.AQ�L)
City:
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Zip Code* Fax:
Phone No. r1--� kE - M ai I NY
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Sate or County License lcz� k L43
If value of construCtIon is 2500 or more, a RECORDED Notice of Commencement Is required, d1pp
If value of HAVC is $7,pSOO or morepr a RECORDED Notice of Commencement Is requIred,
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