HomeMy WebLinkAboutDEAN APP1All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: f '16 Permit Number:
L U c T P
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: POVc-6
PROPOSED IMPROVEMENT LOCATION:
Address: ; vq C4SS(� DA
Property Tax ID #:
Site Plan Name: _
Project Name:
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DETAILED DESCRIPTION OF WORK:
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New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Lot No. Iq
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:
Cost of Construction: $ /'
Sq. Ft. of First Floor:
Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name 1 F V C16 1)Ire/4A/
Name: 14 Ef'V4Al Al c; L.4S q &A.,I
Address: d q C' 551'1 D A
Company: 4- C� CO. VA S
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City: PT PI M C& State: L
Zip Code: 3 tj gigs, `Fax:
Phone No. 771 711 qd d 2—Zip
Address: Y qQ I �0� 1 C
n'! L3 61-f L VP
City:,,OO ,,4L PAi LW?
Code: 3.3 L/(/
Phone No 7 7 'L 3
/3C N Stater` L
Fax;
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E-Mail:
Fill in fee simple Title Holder on next page { if different
from the Owner listed above)
E-Mail 6 C FNAti 73
State or County License,(
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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.