HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED- FOR APPLICATION TO BE ACCEF' 1 TM
Date : Permit" Number : _P_ d.- �
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Building Permit Application
Planning and Development Services
Building and Code HtQulotion Divls7on Commercial _. Residential
1300 Vrglnio Avenue, Fort Pierce FL 34982
Phone: (772) 462- 1553 Fax: (772 ) 462 _15Y8
PERMIT APPLICATION FOR : � /P�� e,..N,., Jam'
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PROPOSED IMPROVEMENT LOCATION :
f Address-,: L. S �H � � r, _ ��t �i3? Teo k'ir Qo� F�, 3Y95 _ mmdml�
Property Tax 11) #: _Y ��/ " Jho , oco 1 - cx"%.A�- �� -- - lot N o .- _, - __
R Site Plan. Name : _ _ ......... __ Block No .
Project Name : -
AML
DETAILED DESCRIPTION OF WORK :-M -A
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New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION :
Additiogal work to be, performed under this permit — check all that apply:
VMechanical _ Gas Tank _ Gas Piping _ Shutters Windows/Doors _ Pond
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Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq . Ft of Construction..o. Sq. Ft. of First floor.
Cost of Construction" $ U t i l i t ie s: _ Sewe r _ Septic 80ding Height ..
OWNER/ LESSEE : CONTRACTOR :
Name �Q Name :
I �. N —
Address: 0 0 / S Company:
City: E' 41 State : �L Addres � 5 W
ZipCode: S Fax: /1r Utr State : /tL
p �j Zip Cc>de*. .3� 95.3 Fax: �
Phone No., 0 � 7� . .3
E-MaRp_ _- - - - - --
PhoneNo
Fill in fee simple Title Holder on next page ( if different E-Mail (2 C2 Q$ Ly
from the Owner listed above) stateorc unty License
if value of construction is 2500 or moire, a RECORDED Notice of Commencement Is required.
If value of H"C Is $7.,500 or more, a RECORDED Notice of Commencement Is required.