HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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e -^ Building Permit Application
Planning and Development Services j
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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:
PROPOSE�`D IMPROVEMENT LOCATION:
Address: M1 t)( I idL
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Property Tax ID#: Mb(I cl �' WLO" 01D" Lot No. I�
Site Plan Name: Block No. fl
Project Name: tennCil d
DETAILED DESCRIPTION OF WORK:
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11f SIMYr
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New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional 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:
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Cost of Construction: Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
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Name (AS OVI U!
Name
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Addre s: I N r" QL4 �. IQC1 0 l VQ
City: 3�1�! 9#&G 1 State:
Company: 7 Y (1 ICLr'I L (t L. L
Address: ,:D'y NVU M( CCWrf1
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City: PISr�L State:-'L.
Zip Code: �JI i�ih-� Fax:
Phone No. -)(S I W1 ILA "l0
Zip Code: ,71-i j u Fax:
E-Maik N i f1 -
Phone No '11T q1 t Z2 � I
Fill in fee simple Title Holder on next page (if different
E-Mail cut1 cy Me (.LCC /f� I 1,
State or County License CRC 1 00ZU
from the Owner listed above)
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.