HomeMy WebLinkAboutPERMITAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
C-'r' _ % Permit Number:
Building Permit Application -
A'anring and Deveiop.rpwnr 5ervxes
6'..1d.ngand Code Reguwion Duvsaon Commercial Ret idenud I
:'ju'0 Yrrgrrva Avenue, fort Pierce Ft 34982
Phone: (7721 462-1553 Fax: J772)d62-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address.
Property Tax ID W. a42.3701 O p �— _ — Lot No.
Site Plan Name: t ,� — Block No.
Project Name:
I DETAILED DESCRIPTION OF WORK: I
-- ►-t�101 t' ^ � '0 Lo'
— L—_
Ne'.v E.ectrical Mete- Seczmd Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply: ,5"C_J'V-0 'J &It,__ { ps V,,,0-
_Mechanical — Gas Tank _ Gas Piping _ Shutters i Windows,"Doors Pond
Electric — Plumbing Sprinklers ^ Generator Root Pitch
Total Sq. Ft of Construction. Yd Sq. Ft. of First Floor: = ._
Cost of Construction: $ ��� w Utilities: _ Sewer — Septic Building Height: l_a-` _
OWNER/LESS EE:
CONTRACTOR:
/
Namt- Rd Le,r�d'fle,Aci 13441 C/LC11+1
htidmr L ��U�..�cLr_
Address: �3z] t7 i.J ,itX Gr L� {„ ✓�_
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Company: ,' rt{c
City: --------- - - _State: ��
Address
Zip Code / Fax: - - ty—p" s, ! 1
City: &-Lgi d,,t- - State: j-rL
Phone No.- 7 01-- 3 70 -
_
Zip Code: 3!1 qq 7 Fax-
E Mail:'f�_r Ya b 0 g"Gam,►-.
Phone No 77' - 14A 7 0
E-Mail 0i,e6(o ar a Y& 1, oa _ e'j2J:Je_
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Fill in fee simple Title Holder on next page ( it different
from the Owner listed above)
State or County License vs
if varue or consiruecion is 25W or more, a RECORDED Notite of Commencement is required -
If value of HAVC is 57.500 or more, a RECORDED Notite of Commencement is required.