HomeMy WebLinkAboutBuilding PermitAll APPLICABLf •:o MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: {Q 12-~} Permit Number: _______ _
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential _ _,/..__ __ _
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (n2) 462-1553 Fax: (n2) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
-----
PropertyTaxlD#: ________________________ _ Lot No. ___ _
Site Plan Name: ________________________ _ Block No. __ _
Project Name: ________________________________ _
I DETAILED DESCRIPTION OF WORK:
New Electrical Meter ____ Second Electrical Meter _____ _
I CONSTRUCTION INFORMATION:
A'7.'.'nal 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: _________ _
Cost of Construction:$ ~WQ.DQ Utilities: _ Sewer _ Septic Building Height: ___ _
OWNER/LESSEE:
Name_..'-""'"'-"....,,.""--'=--------~-+---
Addre~:.u,,...y;::'J---''-'f~.LUo!u:..JLLMo<"'-''--"~"""-----,,c--
City: \1)f:t: . , if [',f_,
Zip Code: :;,.+4,sl Fax: _______ _
PhoneNo. 1-J.\:IZ-:Z41-So33
E-Mail: ______________ _
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name::...MiOCW.LJ~~YJR.:,__ _______ _
~~;:e::~:~~~~~g,~~ ~
City: wt Piu:ce.. State: z:t_
Zip Code: 31,%1 Fax: 1]2:-LU,-3:7 37
Phone No 11lr4C. i • '-114 I
E-Mail boyte.M @,'-('WOO. COQ'\
State or County License CAC 111 ~I '8 (p
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.