HomeMy WebLinkAboutSLCPA Bernardi pg1All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
RUNTY
i o R I c
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Building Permit Application
Commercial Residential
PERMIT TYPE: Pl i,, b; o 1 - weccr hea-ler ch age out
PROPOSED IMPROVEMENT LOCATION:
Address: 1070 i
Property Tax ID #:
Site Plan Name: _
Project Name: _
Dr.
DETAILED DESCRIPTION OF WORK:
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34g57),, ire
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Block No.
I CONSTRUCTION INFORMATION: I
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft, of First Floor:
Cost of Construction: $ Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name:Theoclorl- Zlla
Address: 1070l S. e `D✓iJ
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company: 3lu wak a,ertb-✓gof-AeTeasulcCoast
City: sdJ P!tran
Zip Code: 3L(gg.i Fax:
Phone No. 7$1-3)5 --207
qil' Efate
Address55% AIV Fe✓✓%s-br.
City: Ptl_
Zip Code: 3Ygg' 3 Fax:
Phone No 77a - 30/ - 933
Stater
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
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State or County License C'F-< 14 3
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If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.