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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
�� RECEIVED
o �! JAN 1 5. 1011
Building Permit Application Permitting Department
Planning and Development Services St. Lucie County
8udding and Code Regulation Division Commercial Residential
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:'(772)462-1578
PERMIT APPLICATION FOR:
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Address: 5;U61 LA sTwoo6 FoRr aa=sLc_L FL 34q S 1
Property Tax ID#: INat -613 - oo x -voo -7 Lot No. IMF
Site Plan Name: Block No. t 3g_
Project Name:
OEM
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ALCN Z somni_Ia Mrj" Lute o F Poop"._ A!C'rLrX T'H L E&CT.
New Electrical Meter Second Electrical Meter
NCO �01 S f ,y 4. I NF�,O SAT al",
Additional work to be performed -under this permit—check all that apply:
_Mechanical _Gas Tank —Gas Piping _Shutters i Windows/Doors V Pond
Electric _Plumbing _Sprinklers _Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ �10.010 Utilities: —Sewer _Septic Building Height:
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;Name
1ZOGr_VL A S Htr�rt Name:
,'A,; tddress: �gn� is S wooL1 712tDiL Company:
rCity: 0.T +t'1 = State: L Address:
'Zip Code: 3 LL4S I Fax: City: State:
Phone No' )-1z Zip Code: Fax:
E Mail: ShIr►n 'a.n aaltno Co
►+n Phone No
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) 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.