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Date
INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Ise
Building Permit Application
Planning and tjevelopment services
Building arld Cade Regulation Division
2300 lrirgirria i verve, fort Pierce FL 34982
Phone; (772) 45 -1553 Fax- (772) 462-1578
PERMIT APPLICATION FOR:
PR97P Ec P€ lF E#VT t. CATS
Address:
COD'lt'T ercia
Residential
Property Tax ll� U w Lot Na. _
Site Plan Nam44' Block No. --
Project Name:
FETA-1LED DE CRIPT ON OF WORK :.
pk((n.� S-
#-
New Electrical deter Second Electrical Meter
ON TRUC-MON #NFORMATION,
Additional wo
k to be performed under this
permit -check al I that apply-
Am
ail _ Gas Tank _
Gas Piping _ Shutters � Windows/Doors � P4nd
_Electric
_Plumbing _Sprinklers
-_Generator Roof Pitch
Total Sp, Pt of C
a nst ructi on -.
� Sq. Pt. of First Floor:
Cost of Constru
I ction,
Utilities, _ Seaver _ Septic Building Height'
OWNER/L - EE: _
-. CONTRACTOR. T
Name 61
r r J b.:
Name- }f
Address;
p1b
Company: / pv_ Cori fOrV C
City:
State: T
Address-
Zip Code.
Fax=
City: —EQI- State: FC
Phone No.
(
Zip Cade I ` Fax: i
E ll+iail
_
Phone No 7i
Pill in fee simple
Title Holder on next page ( if different E-Mai!
from the Owner listed above)
State or County License
If value of construction is 25DD or more, a RECORDED Notice of Comme+itement is required.
If value of HAwVC is $7,500 or more, a RECORDED Notice of Commencement is required,