HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COWic i ED FOR APPLICATION TO -BE ACCEPTED
Date:
Permit. Number: ! D Ob d�
' o
Building Permit Application oo� a�eL°��,
Planning and Development Services
�e
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982 'y ^ Residential
Phone: (772) 462-1553 Fax: (772y462-1578
PERMIT APPLICATION FOR:
Address:
Property Tax ID #:
Site Plan Name:
Project Name:
New electrical Meterecond Electrical Meter
Lot N o.- l + a ___.
Block No. _
HQaivon work to be performed under this permit— check all that apply:
—Mechanical —Gas Tank —Gas Piping in '
t; —Shutters _�/in od ws/Door's _Pond
Electric Plumbing —Sprinklers Generator
of &� Pitch
Total Sq. Ft of Construction: _.,� �'� —,
Sq. Ft. of First Floor:.
Cost of Construction: $ 0 0 c� ` �'
Utilities: —Sewer eptis Building Height
Name;
Address:
City:%i�'P•---�
Zip 1�P State:
Code..
Phone No. �� /_ j
E-Mail: . i0�v�h
Fill in fee simple Title Holder on next page ( if different
from -the Owner listed above)
Name:
Company:
Address:,3S3�j,:�
ate;
Zip Code:�
Fax:
Phone No
E-Mail a 5 U Z ►I i
State or County License_ (h C I S_I . .�. / n
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.
plicabe
0 AGE COMPANY.:
Address: 06 city:
R: Not Applicable BONDING COMPANY:
FEE SIMPLE TITLE HOLDE
Name: Address:
Address: oty:
City: Phone: zip: Phone:.
llation as indicated.
OR AFFIDVIT: Application is hereby mad
.'.,St. Lucie Court makesnorepr '-Association bules, bylaws qr!an&6ovenan �t "wNich may apply.
�whilich is 16 to 171 ith any applicablo,Home owners for an rest ions
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-
FLORID. A
asABC-ntf6rowner
`
6 ibed before me of
Apt Presence or Oniine Notarization
making statement -
In OR -Produced Identification
411
ii�=~~!�^
^ �
-of Co act r/ iceiis��Holderff
STATE PF..FL�ORIDA
COUNTY OF
swoen to (or affirmed) and subscribed before me of
online Notarization
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Name of pefsori mastatement-,
Produood|dun�Vcatmn__-___
Penmna| �nown_="°
Type ofidentification
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MANGROVE
PLANS VEGETATION EA.TU
REVIEW REVIEW
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