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HomeMy WebLinkAbout3254 LAKE SHORE DR permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �J 172 Z Permit Number: S`t, LCCCLL i= c Ib `� �- _ 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: _. (�Owa C PROPOSED IMPROVEMENT L CATI N: Address: �)Z�Su i'_ CLVIC Property Tax ID #: 1 LA Zf� c)c) ?> Lot No. Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION OF WORK: ;ram ,.,i _„ exn.I%rvfz'n _\„_, New Electrical Meter Second Electrical Meter I CONSTRUCTION INFORMATION: I Additional work to be performed under this permit— check all that apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters Electric _ Plumbing _ Sprinklers Total Sq.-Ft of Construction: Cost of Construction: $ 1!5 00 Generator vtWindows/Doors Sq. Ft. of First Floor: Roof _ Pond Utilities: —Sewer —Septic Building Height: Pitch OWNERf LESSEE: CONTRACTOR: Name C i m Name: tSoaL P-,5zk,,,c,_ Address: C2& Company: A+-1 rcAn City: kS T&ry C21,-t/C State: A Zip Code: C4 Fax: Phone No. Q�61q — Address: Jr-)H^ cl City: � r-,L_ L-uGL-t Stater Zip Code: 34L-5Z Fax: Phone Nol425-!'Z) E-mail: nuvc 111,21 qci & !)w ui. (aw, Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail Cx f r-(3-1c)cw—a �r cAc,c4r- oa VVICtI 1 .6-�q-. State or County License 7 S 3 btu 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.