HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ?' 6 - 2( Permit Number:
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L' Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce F[ 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Residential
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
~Address: gd1 04#1t g & Parr b-# qSOI - sal - o - 000 - l6
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
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New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all th.?t apply:
Mechanical Gas Tank —Gas Piping _ Shutters _ Windows/Doors _ Pond
Electric —Plumbing _ Sprinklers _ Generator Hoof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 9506 • 60 Utilities: —Sewer —Septic Building Height-
OWNER/LESSEE: CONTRACTOR:
Name 6T o It1d► G4►WL Name: \ar ct f- Ur r
Address: C,, Company: DPJA VA C lrl5.S � C
City: 5'eA r in State: _ Address:
Zip Code: 34 i5l _ Fax: City: Y oC St �. c State: �l
Phone No. 619 Sci - 5.S 30 Zip Code: Fax: 35-33 l n -
E-Mail: Phone No -X3 L4 q
Fill in fee simple Title Holder on next page ( if different E-Mail d d(t+*-r r e Jvdj • CiiM
from the Owner listed above) State or County License G jY1G I Y qR SFI'
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.