HomeMy WebLinkAboutBUILDING PERMIT APPAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
.... ......
. . . . . . . . . .
Permit Number:
Building Permit Application
plrynn;#1 .4
V 0" Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PR�C��QS�D IM��RUV�M�NT LQCATI;01
Address: p�Q j��� tn���
Property Tax ID #:
Site Plan Name:
Project Name: _1k
Commercial __ Residential
Y" V
Y
New Electrical Meter
second Electrical Meter
'Alt
Lot
Block No.
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. ®f First Floor:
Cost of Construction:
$
Utilities: —Sewer Septic Building Height:
Sig _ of Owner/ Le see/Co actor as Agent for owner
STATE OF FLORIDA
COUNTY OF
Swo , n to (or affirmed) and subscribed before me of
Ph osical Presence or _ Online Notarization
this
*-3'��' day of aY R r 2020 b
Name of person making s Cement.
Personally Known - _ CAR Produced Identification
Type of ldentification
(Si na of No- ub ' Sta e rida SHANN
COMMISSION #GG026573
Commission No.
�: :�►MY
s IRES: SEP 05, 2020
Ened through 1 st State Insurance
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Sign-�rtafe of Contractorft;cense older
STATE OF FLORIDA r
COUNTY CIF
Swom-d,to (or affirmed) and subscribed before me of
.Physical Presence or online Notarization
this day of 2020 by
Name of person making staterrd.nt.
Personally Known CAR Produced Identification
Type of. Identification
Prod
(Sig tur d Try u at o ida } SHANNO N DEPUE
= . My COMMISSION #GG026573
Commission No. ... _ Seed MIRES: SEP 05 202
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Bonded through 1 g st State Insurancf
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