HomeMy WebLinkAboutmcampbell.appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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: A ( C (2Vzviw C
I PROPOSED IMPROVEMENT LOCATION: v I
Address
Property Tax ID #: Lot No.
Site Plan Name: uu f,caIV)oGam. I I Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
i kr' - -k) r I i ICE
uni-�
New Electrical Meter
Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
U echanical _ Gas Tank —Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ (a/
_ Generator
Sq. Ft. of First Floor:
0
Windows/Doors _ Pond
Roof Pitch
Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name: 50cbucs ECG %2 c:: S
Company: 4� r I)QC<'- Of +VV TftC(S t.r _ (0&
Address: ����Jl �JC?�sk� rlea'4'
City: ek . $.cwGk-- State: JPL--
Zip Code: 31LY9 5-A Fax:
Phone No. (T7A 3421 " Y50
Address:
City: vv-o Gi C'iln State: Pi -
Zip Code: :�ZGi Le Fax:
Phone No
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail Cl CA0C3 60 rr.G6i.) 6
State or County License V--.Pl I . --I
If value of construction is 2500 or more, a RECORDED Notice of Commencement is requirea.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.