HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date; - �— Permit Number*.
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MFT-413
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fart Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: c-
PROP 0 A'OVE` t TLO
Address: 0 S. 0CsZ4 V'. Q FL- 3 H1�
Legal Description:
Property Tax ID #: +~� .] `1 `�� i - c�o�a - O� Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front_ Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
CONSTRUCTION INFORMATION:
A %MiQna wor< to e per orme unde�is permit— c ec a tat app y:
echanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric — Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $�• Utilities: —Sewer _Septic Building Height:
Names e Name:
Address: i0 S '� Company: r5
City: State: LL— Address: 3 S.bJ- (.
Zip Code:_ Fax: City: r State:_
Phone No"
S Zip Code: Fax:
Fax:
E Mail: Phone No11
Fill in fee simple Title Holder on next page ( if different E-Mail rV 0,A�� WW'C5& '(\e,
ou
from the Owner listed above) State or Cnty License MC 'Sl LAnQ
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. --
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