HomeMy WebLinkAboutMosher Permit App (2)All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
p 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
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address:
Property Tax ID #: 24"DL " (/ D2- " OZ®C ^ CM - ® Lot No.
Site Plan Name: Block No. U
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Project Name: DL-fn2C 21 Pik
DETAILED DESCRIPTION OF WORK: 1(` cam'iS}zY�j v� GpLz�l t bc'rn t,c� �r�5pecj
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CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
—Mechanical—GasTank _Gas Piping „Shutters Window Doors Pond
_ Electric _ Plumbing —Sprinklers _ Generator _ Roof_ Pitch
Total Sq. Ft of Construction: ` 3 ?J
Cost of Construction: $ 29. goo, 00
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEC.
E.
CONTRACTOR:
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Name p ➢ca S� ii���-V��h�
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Name: C /J Cq
Address: I bteloaw-r)
Company: U )/7S
City: aMn �erw State:
Zip Code: 3�6852 Fax:
Phone No.
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Address: M� 5I=5 A.�t�f2 &ACLC
City: +Slbte,LL_ State:oDp
Zip Code: �n4c52 Fax:
Phone No` 92- L0402Cob
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
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E-Mail au" �) 1('Y i��� �r;'/✓i
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.