HomeMy WebLinkAboutBuilding Permit Application 1
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ✓-� � Permit Number: O�
CCTLD A
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:
Address: l/ ! / �✓ q
Property Tax I D#: �j' �"� / / �� Lot No.
Site Plan Name: Block No.
Project Name: 'w18��t'la,.�
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w Electrical Meter Second Electrical Meter
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank —Gas Piping _Shutters _Windows/Doors _ Pond
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
14
Cost of Construction: $ ( G .la, Utilities: —Sewer _Septic Buildin fight:
Name Name:
o
Address: r7 Compan
City: L° Stater Ad ss: io
Zip Cod Fax: ity: State:
Phone No. de: Fax:
E-Mail: Phone No
Fill in fee simple Title Holder on next page(if different E-Mail A,(Or� �MA1
from the Owner listed above) State or C y License C�oC
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.