HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICA LE IN F MUST HE COMPLETED FOR APPLICATION TO BE ACCEPTER
Date: -7 } Permit Number:
t)_ U o LLUC 415 1
. Building Permit Application
?funning and Deve0prrrent Services
Building and Code Reyufotion Division C .}nifTl�rCl�� � Residential
2300 Virginia Avenue, Fort pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Address: C b �^ vt4
Property Tax ID #: 3,4 1' - fU Lot No. _
Site Plan Name: Block N^
ti
Project Name:
New Aectrical MU eter 5ecoad Electrical Meter (Affidavit required
II FQRMATiON
Additional work to be performed under this permit -check all that apply:
—Mechanical _ Gas Tank , Gas Wiping � Shutters , WindowslOoors _ Pond
Electric Plumbing , Sprinklers Generator ZL._ Roof Pitch
Total Sq. Ft of Construction: —iJ Sq. Ft. of First Floor:
Cost of Construction: $ 1I r ) 2. Utilities: —Sewer _Septic Building Height
Name hl.L _; ` �}OYZ(dt Name; M ` ; 1r1 ! 1 11 1 tV rt•111Iu
` fJI,U Vk `
Addr s: r�S �+��� Company. t•
City. r�i State, j : Addr s:
Zip Code: Fax: Cit : L State:
Phone J zipCod Fax:
E Mai Y1L�Jif r one ❑ 1
Fill in fee simple m- Holder on next page ( if d er . E-mail r
from the Owner listed above) State or County Liens j
if value of construction is 2500 a more, a RECORDED Notice of Commencement is required.
if value of HAVC is 57,500 or more, a RECORDED Notice cf Commencement is required.