HomeMy WebLinkAboutBuilding Permit Application Page 1All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TD BE ACCEPTED
Date: Permit Number_
O i
4 1� Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34952
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT
Address: 1 -r '
Property Tax ID ;
Site Plan Name:
Project Name: -/Jdt) r h,./r►
i?vim a Be)e J,4,,
DETAILED DESCRJPTI N OF WORK '
I!
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New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION.
n �7
Lot No.
Block No_
Additional work to be performed under this permit— check all that apply:
`Mechanical — Gas Tank ` Gas Piping
-4Electric _ Plumbing — Sprinklers
_ Shutters _ Windows/Doors _ Pond
^ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Sq. Ft. of First Floor:
Cost of Construction: $ ... � � Utilities: —Sewer _Septic
Building Height:
OWNE
CONTRACTOR._
Name
Name: �'r'
�T
Address:
Company: -57
City: State: _
Address: 9
e
City.
Stater
Zip Code: Fax:
Phone No.
Zip Code:—1
-
Fax:
_
E-Mail:
Phone No 77 --
F ,) '7,9 `-7
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or /county License
- G -1 % L/
If value of construction is 25M 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.