HomeMy WebLinkAboutPermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number:
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L= L 0 'L' �� �� � � Building Permit Application
Planning and Development Services
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Building and Code Regulation Division Commercial ResidentialC'--=%
2300 Virginia Avenue, Fort Pierce FL 34.982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 36 0 � -fcJ �' %���
Property Tax ID#:Ds^'S Lot No.
Site Plan Name: 5 4212 42,' Se 06i /9Cd 'i7`lBlock No.
Project Name: /4Z;Z 0 200,3 6eic % Z�22�
DETAILED DESCRIPTION OF WORK:
4; o n
New Electrical Meter tAf > Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit --check all that apply:
Mechanical _ Gas Tank _ Gas Piping _ Shutters
Electric Plumbing _Sprinklers _Generator
Total Sq. Ft of Construction: / 0 �v /' D Sq. Ft. of First Floo
Windows/Doors _ Pond
Roof _ ��� Pitch
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Cost of Construction: $ � �� Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name_ ei/� i9 �'YQ/1 S
Name:
Address:
Company: /V11i9
City: 041/41�h Stater
Zip Code: '5_tTa U Fax:'946'6-1-O 7/U
Phone No. --Olt- 600— fZ3 3
E-Mail: k/1'!1 647bwaz_j° Cfo
Address: ,534�/ ZCZ oa�G
City: %u 71-4 State: fi9
Zip Code: 55 8-0 1 FFJax:21$ 56/2y71U
Phone No o2_1 C� �CoCX�— /�3�3
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail(a) /07��>
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.