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Permit Information - Permit 21040354

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Permit Information
Permit Number	21040354	STRAP NBR	C-29-36-30-030-0220-0120
Permit Type	BROOF	Balance Due	$0.00
Property Address	1604 CHURCHILL ST	Status	Closed

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Permit

Permit Information
Application Date	04-13-2021	Operator	hcopelan
Issued Date	04-13-2021	Operator	hcopelan
Master Number		Project Number
C.O. Number	20136146	Operator	sarnold
C.O. Issued	05-04-2021
C-404 Type		Usage Class	NA
Applied Value	8695	Units	0
Calculated Value	0	Contractor ID	HC04189

Property On Permit
STRAP NBR	C-29-36-30-030-0220-0120
Unit
Address	1604 CHURCHILL ST
City/State/Zip	LAKE PLACID, FL 33852

Owner On Permit
Name	FORNEY DALE E + CAROL A
Address	1604 CHURCHILL ST
City/State/Zip	LAKE PLACID, FL 33852
Type	Private

Applicant
Name	FORNEY DALE E + CAROL A
Address	1604 CHURCHILL ST
City/State/Zip	LAKE PLACID, FL 33852
Type	Owner

Miscellaneous Information / Notes

REMOVE&REPLACE W/23-SQ, 5/12-PITCH, PEELNSTICK

SHINGLES, 2SQ TPO 2" INSULATION

NOTE: PROPERTY WAS SUBDIVIDED APRIL 2024. WAS

ORIGINALLY LOT 12 & 13... DIVIDED PROPERTY TO

BUILD NEW HOUS ON LOT 12, THIS PERMIT IS FOR THE

HOUSE ON LOT 13.

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