HomeMy WebLinkAboutBuilding Permit ApplicationAll AppLIr_ABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1
Permit Number:
-4 -71�-
Plannin Building Permit Application
9 and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
�ROPO�SEDIMPROVEMENT LOCATION:
L
Address:
Property Tax ID #:
Site Plan Name: _
Project Name:
0v1-6l, 0 -6 �7q -Dw-
DETAILED DESCRIPTION OF WORK:
1`iS-C
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
echanical _ Gas Tank _ Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction:
Cost of Construction: $
OWNER/LESSEE: Yc;)A-r
Residential
Lot No. d�
Block No.
_ Windows/Doors _ Pond
Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic
t
Name +
Address: �Q O Q
cJ i -e C1,4 State: '
City.
Zip Code: �� Fax:
-� a �i 0
Phone No.
E-Mail:
S_A—�
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
Name:
Company:
Address: L 1
City:
Zip Code:
Phone No
E-Mail CI i
State or County License_
Building Height:
Ave
State:
Fax:
If value of construn is 25
ctio00 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.