HomeMy WebLinkAboutCONNELY PERMIT APP PAGE 1 NOWAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Permit Number:
Building Permit Application
Commercial Residential
�k-
Property Tax ID #: -e 3 Lot No.
Site Plan Name: Co V• coVP--%5 e S C /-[ ri1 v/ e' Block No.
Project Name: "�
Additional work to be performed under this perrf"iit —check all that apply:
Mechanical. _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
_ Electric Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: / Sq. Ft. of First Floor: J
Cost of Construction: $ Utilities: —Sewer _Septic Building Height:
Name T11 UigC Cori a C//
Address: G -2
City: I -eVc-'e State:
Zip Code: 3't Fax:
Phone No.
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: rat V— 6 Q - H" Vi i a f-te- �
Company: K 1 VC4, Cc, V•e✓ 1
Address: 3e, e K d
City: c Ce Stater
Zip Code: , 3 Y" <T -:)L— Fax: b —Iff `e
Phone No 77 I --q1-6-3 It
E -Mail A I Iq C., a -cp- ue<w
State or Coufdy License 19,
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.