HomeMy WebLinkAboutFAITH CONTEAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9,l'?-\ 1 02 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Residential
PERMIT APPLICATION FOR: L FC�T��\ CAL
PROPOSED IMPROVEMENT LOCATION:
Address: (�- 1, TIVW � P'\N L
Property Tax ID #: �J�\Ly ` �� \ - 0'2)53-CD)0 q Lot No. `C\)
Site Plan Name: W%> I+P C A -\I Block No.
Project Name:
DETAILED DESCRIPTION OF WORK.
C✓Y1 tJryc� \ a , � �� \ 0-\ � UJA 4c) n-,
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit - check all that apply:
Mechanical Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ \ Q>l-s Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name G�-\i, '�tY -
Name: Y ' 1-(l
U-J0�—
Address: 4 - �.�ct'��S - ,-2
Company: l 1 lAt� (-
LL-
City: t LL � - state
Address: )r\\() \\() Lk� fi,' A .
Zip Code: .��ol�Sa- Fax:
City:
Stater 1
Phone No. ��� ��� y _
Zip Code: ?�A (�oZ Fax:
Phone No 4 L a�
-A%9\-U\! A j
E -Mail:
Fill in fee simple Title Holder on next page ( if different
E -Mail �\C�\1�S1'`4�'A UA&
OkCS, CQA
from the Owner listed above)
State or County License �C��.��
1 (r)'4
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.