HomeMy WebLinkAboutSalle app pg 1All APPLICABLE INFO MuST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: '| `7_2L-1A Permit Number:
SffoELou@HEEOuEu..-uyffirs Building permitApplication
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2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PRorosED ,MPROVEMENT LOCAT,ON: RE--r f~"-' -,.„`RE,i r ,f,., '.-€. -_"
Address: \C)goo Sar:.erAlnbf.# (o\O
propertyTax lD #: uS\\ ` S\8 -DC]5B -r\C)0 ~a- Lot No.SiteplanName:C\ncL.h`|TLA.IThi.4pci_BlockNo.
Project Name:
DETAILED DEscRipTioN OF wORKfa* .tf`.
`EeT>\ace_ \\\£p +:r \\to T5 Tor` CLonri€Asg>+ Or`\U`________ _ I
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTloN INFORMATION :
Additional work to be performed under this permit -check all that apply:
LMechanical Gas Tank Gas piping Shutters Windows/Doors Pond
Electric Plumbing _ Sprinklers Generator Roof Pitch
Total sq. Ft of construction:. Sq. Ft. of First Floor:
Costofconstruction:$ 33C\t.oO Utilities: Sewer _Septic BuildingHeight:
OWNER/LESSEE: g+REi`ife"`CONTRACTOR:
Name S;\e~\\u Sci\\C,e Name: ut`rf=,h+\\ Ha7,2i-\\ i
Address: 2a`f) I . P\ch€au i>\company: the+ A^r \v`c.
city: Ct)\or"nr`hckot` StateEL|Address: 2ulq ,a n Cthinr`fu SLD\ AriL
city:?a-\trn cLh4 ' St;te:jillzipcode: qlqfui`\ Fax: j?/a`gau-allJ9
phone No.Q I a ` adefi - n2\ S Zipcode: 5lidQr) Fax: 112~ZS2,~l``G
E-Mail: N\A Phone No 117_-2J32+~I I I VLFIIIlnfeesimple Title Holder on neat page ( if different E-Mail mfo@_\r`c]np,f±+airlr`r,. rrw`
State or County license CflcLr)Sidso¥from the O`rmer listed above)
lf value of constructlon ls 2500 or more, a RECORDED Notice of Commencement ls required.
lf value Of HAVC ls $7,500 or more, a RECORDED Notice of Commencement ls required.