HomeMy WebLinkAboutappiicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date. -1 %'q " %11 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commel"ciai Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Ne l
PROPOSED IMPROVEMENT LOCATION:
Address: c(66 toe5 e ivk
3•040
Property Tax ID #: Lot No.
Block No.
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Sf c.-ov l d ka UJAI' [ o "Kw h-e44k.f
(Affidavit required)
Additional work to be performed under this permit-- check all that apply:
Mechanical _ Gas Tank Gas Piping r Shutters Windows/Doors _ Pond
Electric — Plumbing _ Sprinklers — Generator , Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 1196d. o
OWNER/LESSEE:
Sq. Ft. of First Floor:
Utilities: Sewer _Septic Building Height:
Name �lJe�f
Address: 6Io Nel'II�S i3�J
City: '�C'.n State: �I
Zip Code: 34 riFax:
Phone No. 5-10 " 4Sl . 49b
5 5-
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed alcove)
CONTRACTOR:
Name:
Company: Q o
Address:
City: 9-0—r+ State: I
Zip Code: Fax: 33! -3 l0
Phone No 3�`5 -'t3 '•(9
E-Mail �� Lr, fti t5 P du Acd • CO - —
State or County License C-W. I3Lrlf
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.