HomeMy WebLinkAboutBuildingt permit app pg 1All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ljfq{z.1 PermitNumber: ______ _ ~ I
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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:
PROPOSED IMPROVEMENT LOCATION:
Address: 111
Property Tax ID II: ll-Z-ZJ.l ~ 50 l AO 6 3 J. • 00 -I.,
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lot No. ___ _
Site Plan Name: _______________________ _ Block No. __ _
Project Name: ______________________________ _
DETAILED DESCRIPTION OF WORK:
New Electrical Meter ____ Second Electrical Meter _____ _
I CONSTRUCTION INFORMATtON:
A~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:$ !f300, OD Utilities: _ Sewer _ Septic Building Height: ___ _
OWNER/lESSEE:
Name.__,,....="-'-"'-L--..1.,;C""-""-"---'--------
Addre:=::_._.,,,,::i..,..,,,._.-,...~J.'1.!"""l..!.-~=,4---=-
City:-+"'-"mh~"""-""-------State: y(..,
Zip -~~....__,-.~
Phone No .. ___.__...~--'------'-"--'---------
E-Mail: ______________ _
Fill in fee simple Title Holder on next page ( if different
from the Owner rlSted above)
CONTRACTOR:
Name::__Mi{ll(MJLJ;~~~----,------
Company.&~t ~~~~~~ 1k
Address: .'?!_llSA1~~ 14_.
City: fT)(,b l>iure... State: It,
Zip Code: WI Fax: 1]:J.-J.i,f,,-3137
Phone No 111,-L((, I • -'-1 l 4 I
E-Mail boyf e.a!!. @,'-(WOO; ro cY\
State or County License CAC l 'ii ~I a (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.