HomeMy WebLinkAboutBUILDING PERMIT APPLICATION PAGE 1All APP= MUST BE COMPLETED 1 013 APPLICATION TO BE ACCEPTED
Date: Permit Number;
Building Permit Application
Pbnning and evelopmentServices
Building and Ode Regulation Divisian Commercial
2.300 Virginia venue, Fort Pierce FE 34922
Phone; (772 4b2-1553 Fax: (772) 462-1578
PERMIT APPLI ATION FOR:
PROP S Ill PROVEMENT L0.0 TI.0N:
Address: �-
Property Tax I #; 6 z — occ
Site Plan Name-1
Project Name-.
Residential �
Lot No----'
Block No -
1
New EleLctrical�Meter Second Electrical Meter —
— . (Affidavit required]
CON TRU TION INFORMATION: *_ ,
Additional wok
to be performed under this permit — check all that apply;
;Mechani
aJ — Gas Tank _ Ga5 Piping
— Shutters _ Windows/Doors _ Pond
Electric
-- Plumbing _ Sprinklers
_ Generator
Roof Pitch
Total Sq. Ft of
onstruction:
Sq- Ft. of First Floor:
Cast of Constr
CUO'n'. $ _ Utilities;
— Sewer , Septic
Building Height:
0WNER/L
SSE ,
CO 7 2 T R-
-.
Name
t—
Name,
J 2
Address'
Company_ JQ
YT, ,
r ce State:
City'
Address;
i Zip Code: _
1`ax;
City- ��
State;
Phone No.
1 ., �
Zip Code: ` _ Fax'
E-Mail:
_
Phone No
Fill in fee simple
Title Holder on next page ( if different
E-Mail
� I
from the Owi
ier Ilsted above]
State or County Lice nse
If value of constiuction is 2500 or more, a RECORDED No#ice of Commencement is retluired
If value of HAVCiis $7,S00 or more, a RECORDE1) Notice of Commencement Is require4.