HomeMy WebLinkAboutBUILDING PERMIT APP, PG 1All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: IU
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: q I C) i ` ' J
cc C. ?IL 3-
Property Tax ID f;: 5,9v;�'r 661 r O CO — d Lot No.
Site Plan Name:
Project Name: lcero(') 4C
Block No.
DETAILED DESCRIPTION OF WORK:
�- 01
D \,A a its SS AA _i s P 1 I.I s bay C l e')5-f-a I I
l a, 11 SI&.n) oG K_ Cb0-f and C-C itn_'i 1 ('cc, f— ctr--
New Electrical Meter _A- Second Electrical Meter ���la_ toU6sq i � ---I-
I CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank
Electric _ Plumbing
Gas Piping T Shutters
_Sprinklers _Generator
Window oors _ Pond
oof Pitch
Total Sq. Ft of Construction: (k rV `� �' Sq. Ft. of First Floor: Sc
Cost of Construction: $ j t7 e 0 Utilities: —Sewer —Septic Building Height: I �'
OWNER/LESSEE: I CONTRACTOR:
Name_ K —e sef A:_s�_f ce T UY7 :1za�
Address:
City: (_i State: rL
Zip Code: 3 215 Fax: _ --a ) Ci
Phone No. -7 -7 a ~ q (0 o �
E-Mail: OS_� , �Lil►�f �_YL't_G+LMU1 .�ofY`
Fill in fee simple Title holder on next page ( if different
from the Owner listed above)
Name:
Company:S s �&Fi�g �- C.
Address: 10 o_ 5 /V E T4%AASn � (3%v d-
City: I Q _C'6 State: �L
Zip Code: 5 y S Fax:
Phone No - 3 d I
"ail 5 R7Gf1R 1(I( Cti f17' .' 1_C011
Stafe�r County License CC C o a VqI -I-
It value OT consuucuon ts zauu or more, a Kt(.,UKDED Notice of Commencement Is required.
if value of HAVC Is $7,5W or more, a RECORDED Notice of Commencement Is required.