HomeMy WebLinkAboutbuilding permitAll APPLICABLg INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �/ I61/ Permit Number:
c L o`.- Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-15S3 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
zPROPOSED IMPROVEMENT LOCATION:
Address: /3 N131�_w-3 vFjus
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter ISTiP& %aZ,
CONSTRUCTION INFORMATION`:' s
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 Constructi n: Sq. Ft. of First Floor: _
Cost of Construction: $ :� �� Utilities: Sewer Septic
Building Height:
OWNER/LESSEE.
CONTRACTOR:
Name �A
I N1A L F 4S
Name: 0rTTM
Address: 5$3l0 AJpi~i=v %UF_M0f_
City: Fr State: F-L
Zip Code: Fax:
_
Phone No. (747- 0 -701-
E-Mail:_ '5Few�R700* 43! "" Ct�-%li_ • r "'I
Company: 0-46 F-o-iziC UL
Address: rV WWP P
City:
Y: FI State: fLI
Zip Code: 5i Fax:
Phone No (77Z�Z06cl
E-Mail 5AV517AP 4�95e yAma)awo
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License F—L )54f� 9> 5
If vg14C UI GVIMFULLIon IS tavu or more, a KLLU cUtU Notice of commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.