HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ��II c/�C)/
Permit Number: z/og - V %
Date:
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® Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
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Site Plan Name: Block No.
Project Name: IOC rC2✓ 9-7 (`S (/Jc'�L lZ
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit -check all that apply:
"(Mechanical
_ Gas Tank
—Gas Piping
_ Shutters
Windows/Doors _
Pond
Electric
5(1�lumbing
_Sprinklers
_Generator
X Roof
Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor: I f G'J
Lost of Construction: $ Utilities: D4 Sewer Septic Building Height:
Name nt d V11A$ ILO r5i ?I R0CTe-y'
Address: 5o v f 14 ()CCe b2 / o-t-
city: N>( f7Cy9CY State: L-L
Zip Code: 19 1-5 D Fax: G C,
Phone No.-? - -71 0 p �511
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: LJ&(-4Nw i-/
Company: DL?LA)-I v� eo ;Stit, Ci u
Address: y06 .N u 5r KQ:AI TC/tn•9C
City: (^ .SC OcC%, If State: t�L
Zip Code: 3� /c s Fax:
Phone No
E-MailCac.la(cJ^% 0LLO9VV t/C8^ YM'JCilu
State or County
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.
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