HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 - 1- .11 Permit Number:
. 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
P�RMITAPPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 1 0_'7 0 GegwN q `f Sh 11 - 000 - i
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
New Electrical Meter
Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed underthis permit - check all that apply:
_Mechanical _ Gas Tank —Gas Piping — Shutters
t 16
(Affidavit required)
_ Windows/Doors _ Pond
Electric _ Plumbing _ Sprinklers — Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ L4 S 00 . Q U
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name SeLip.5irtaName:
Address: S. c+Pwh Dr -W -11q
City: J State:
Vmr t (Z Cfiir6,.Y)
Company: 06,AJ EAA-cran5ie5
Address: t* —zf1 4T7tk� �
Zip Code: 31qt15-1 Fax:
City: I�a��- S� LyGa-C Stater
Phone No. C 3 I -$
zip Code: 341 SX Fax: 335.33 I O
E-Mail:
Fill in fee simple Title Holder on next page ( if different
Phone No S95. a 3 If
E-Mail ,A AeA+eQi-,sts 0 , cwftm
from the Owner listed above)
State or County License Gfn C 1 q9 58'
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,S00 or more, a RECORDED Notice of Commencement is required.