HomeMy Public PortalAboutLEWIS AV_156.pdfDATE ISSUED: 12-17-2014
WORK DESCRIP'll [ON
WORK LOCATION
OWNER NAME
ADDRESS
CITY, ST, ZIP
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CON,rRACTOR NAME
ADDRESS
CITY STATE ZIP
PROJECT VALUATION
M:
J Rill
1 40
CITY OF TYBEE ISLAND
MECH - INSIDE UNIT ONLY
156 LEWIS AVE
JIM NICKERSON
PO BOX 1412
TYBEE ISLAND CA 31328-1412
C TAOMAS KIRK
166 LEWIS AVE
TYBEE, ISLAND GA 31311,
P
$ 5�0.00
4-0004-14-020
PERMIT #: 14081,9
TOTAL BALANCE D U E: $ 50.00
It is understood that if this permit is granted the builder will at all times comply with the zoning,subc1h,ision, flood control, building, fire, still
and sedimentation, wetlands, marshlands protection and shore protection ordinances and codes whether local, state or federal, including all
environmental taws and regulations when applicable, subsequent owners should be informed that any alterations to the property must be
approved by the issuance of another building permit. Permit holder agrees to hold the City ofTybee Island harmless on any construction
covered by this permit.
This permit most he posted in a conspicuous location in the front ol'building and protected from the weather. If this permit is not posted work
will be stopped. The building contractor will replace curb paving and gutter broken during construction. This permit will be voided unless
work has begun within six months ol'the date of issuance.
Signature of Building Inspector or Authorized Agent:
P. 0. Box 27,49 - 403 Butler ANenne, Tybee Island, Gvur is 31328
(912) 786-4573 - FAX (912) 786-9539
www.cilyoflybee.org
Location of work (street address)
Contractor
Address of contractor � .,
Contact name & telephone number of contractor
Name of property owner V,'
Mailing address of property owner k
Telephone number of property owner
Residential Commercial
New Work Replacement
Details of project M hL
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Estimated cost of constr-uction
Permit Number
Date work will be ready for inspection, if known Li
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wrier/Contractor signat re Date
Owner/Contractor printed name