HomeMy WebLinkAboutrevised 10/1/20All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date. rr ry -
f's Permit Nur>�ber:.(�
L'29
Building Permit Appiica ion
Ptaming and Development Services `0�i"„i, tt I.
Burfding and Code Regulotron Division - 1
COrnmerCl21 esidtyfttial'-'
2300 Virginio Avenue, Fort Pierce FL 34982
Phone: (772)462.1553 Fax. (772) 462-1578
PERMIT APPLICATION FOR:
Address:
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name: S * kw
154
,� c V'-z -o j�•c $ t :� U
'� as � 1 i L.. _ � s + 1 + •.
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I b Z i� •fit
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New Efectricar Meter
Second Electrical Meter a am e irl
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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 ConstructiX Clities: _Sewer Septic Building Height,
ilo rr,4.er
) Name
Name: j ( -
Address: Q(RoN nea± 1-„ EL
Company:
i City: Stater
Address: Y it
Zip Lode: Fax:
City. ���� a
Phone No. -
- ^State:
Zip Code: Fax:
E Mail: ((!Y + IM ,
i Phone No
Fill in fee simple Title Holder on next page (if different
I' E-Mail '/1� r
from the Ownerlisted above}
State or County License
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.