HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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Building Permit Application
Planning and Development Services J
Building and Code Regulation Division Commercial Residential K
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR: Wec kn,-CaJ
PROPOSED IMPROVEMENT LOCATION:
Add ress: 3 o c e l .1) SDI - O t{ - 000 - a
Property Tax ID#: Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
o mot` 3 4V& ILf r 5+ C001 un�f-- 10 I1C w k r
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 J Generator hoof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ q S60 . Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: Fe:
TOR:
Name `"r A. Zpc F. Carbrye
Address: 363 �5eA{Le5 S1� _ odd n4f' Se5 G
City: State: Add re s• --q(n 5� i3G 5'K+G 1 &I LI ,--
Zip Code: 34C1 S 7 Fax: City: er S�' 1--kGt State: I
Phone No. - $ I - g 19 3 Zip Code: 34elS*�, Fax: 33 5 ~33►y
E-Mail: Phone No 3 14
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License C36L\C I A II g all 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.