HomeMy WebLinkAboutApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -1' 6 - a`) Permit Number:
'TX5 4Building 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:
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Address; 0 tg ies A Q+xG l SI)it:' 95oSo I - oyay- 0ae-
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
+ 40.01 0 k-A WA; _k 16
V
\i ice 4 r 11'v
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
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cast of Construction: $ 45_0Q - &!
(Affidavit required)
Windows/Doors _ Pond
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: _ Sewer T Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name TnS*q hnr D!g�rrfto• l'� _
Address: C46(
Name: arkGC
God A
Company: 0411En�Lf~
i5�5
City: T eii1n &^&K _ State: _
Zip Code: 34�51 Fax:
Phone No. f 773) 30$- 0q 31 _
Address: I � S E
9L rl
City: Oo& s' Lucc'e
Zip Code: 3 q C? S dL
Phone No+ 39'
E-Mail
State: rrl
Fax: 335.331�
14
Cow
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License
G M C !
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.