HomeMy WebLinkAboutApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4I 2ol it Permit Number:
c L C' c Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential i(
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION: J
Address: L L) E ► ,roc>ti � e F+ . I i � �,�'IG c� i
Property Tax ID #: 1i00c'i Lot No. �
Site Plan Name: Block No. J
Project Name: I; c,zL
DETAILED DESCRIPTION OF WORK:
5-131 Ark c S1 �i n(alc V�2 -" } CY r (� icy II rY; i>1 c; , , �}r';c C'+ S rub(Lel C 05,
New Electrical Meter Second Electrical Meter
I CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
Mechanical
_ Electric
_ Gas Tank
Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 1 ��� (")
Gas Piping
Sprinklers
Shutters
Generator
Sq. Ft. of First Floor:
Windows/Doors
i Roof H
Utilities: —Sewer —Septic Building Height:
Pond
Pitch
OWNER/LESSEE:
CONTRACTOR:
Named VCj1'j 1)0'_SI-(-) ;,,�5
Name: ��c%ilelG�
ca 0,c
Address: ' '�'� r c; �:� iv�'
Company:CN,S
Ck- EL 1 l
City:_ Stater
Zip Code: `2.sLJq E73 1 Fax:
Phone No.A4-- �,- C C�
Address: C)H I(c o nCc f
City: S4-_ 'I��_,��1
Zip Code: ?;TI1 l�
Phone No ZL(i-j
�-rr Stater
Fax:
lO
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail��"���Ir �C �tiS��_, • Gc:�Y�
State or County License ('c'e
It 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.