HomeMy WebLinkAboutpermit application p1All APPLICABIllE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: S 3U ZOZO Permit Number:
- L _770' ri Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial__ Residential
1300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:�' 1'r
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PROPOSED IMPROVEMENT LOCATION:
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Address: r��OS' A4QRt'ti,4 en, ., 1 -J,(Jguq
Property Tax ID »:
Site Plan Name:
Project Name:
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DETAILED DESCRIPTION OF WORK:
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New Electrical Meter Second Electrical Meter
I CONSTRUCTION INFORMATION:
Lot No.
Block No.
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors _ Pond
V. Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
CFO
Cost of Construction: $ ?— 360 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name 2< 1 c (c ,�'rs
Name: i 2 t
Address: 12,312 s. Q„ cf
Company: G i
City:State:
Zip Code: Fax:
Phone No. q 1 i - 1? 2-- SbRo
Address: 1q0 ;rN
City: S L Stater
Zip Code: 3ti1qS3 Fax:
PhoneNc 2-Z1 - Ll928
E -Mail: Czm
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
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E -Mail VLS ,
State or County License CC I .
- -- - -... - --• " - - Y "&� WMucu MUMU or �ommencemenz is regwrea.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.