HomeMy WebLinkAboutPermit app Raul Montero 1 All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
0
• 1; 1n, rti - 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: t7 S r.L 17 ry E 3oZ` V.n scan t3 Ft, 3 4q!7
PropertyTax ID#: Lot No.
Site Plan Name: Block No.
Project Name: E r-GSS c�a ►� u.rw1 +� tk�k 3p2_ �-E ra iSt�i bawl
DETAILED DESCRIPTION OF WORK:
ZP,A! 1"tea uo %}-In S.?
en up ►SLO , s vJ ,►l L-( V I Al& laces W ,1.4� �• • SAO 7
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit-check all that apply:
Mechanical _Gas Tank —Gas Piping _Shutters _Windows/Doors _ Pond
✓ Eiectric _Plumbing _Sprinklers Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ ?=)c00.a� Utilities: Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name r► �" Name: 1:>p-uL% uk
Address: l ZA.P p" Company:_ p�lrG� r.L E� trtft-►t=,�riC.
City: rY► State:� Address: S40 �3(p�-in Tt,rr`t,�c e_ �,,►.'��
Zip Code:3 30 Z"l Fax: City: Zducck pArvr ae+4-C*-\ State: V-Phone No.5 5 2, 3 LA le Zip Code: Fax: A
E-Mail: G r,-t,Mdn „ a J, o2 Phone No„ ol. '7 LOSS 3
Fill in fee simple Title Holder on next page( if different E-Mail
from the Owner listed above) State or County License Cr Z') $
If value of construction is 2500 or more,a RECORDED Notice of Commencement is re uired.
If value of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required. =j