HomeMy WebLinkAboutkings plaza waterline (1)All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �26 Permit Number:
17-19MMMOMW U ` Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: jnSia`\ wa-wvk 1 rvel - O M.0 +
PROPOSED IMPROVEMENT LOCATION:
Address:
Property Tax ID #: 3 (422-- LA • WO) - DSO -
Site Plan Name:
Project Name: _ Cno IVV G,
0
L.4
Lot No.
Block No.
W eA-ex -t-D
Doc —y= OLti).
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
Total Sq. Ft of Construction:
Cost of Construction: $ �,� • W
_ Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name )p
Name: henjam�rt ,
Address:�30 �JW N . pY-W4C 6`VCL•
Company:E&A )Quyy\iCN D(CW 'S PlUrnlpiOCA
City: Povfi E3t - wcl -e- State: V-L
Zip Code: 3L[CiOLP Fax:
Phone No.
Address: 4«^i ggUna� 6IVOL
City: F-0yt" 91'eI(C-P— State: -FL
Zip Code: e gcis 1 Fax:
Phone No n-2- - $`1-1- Zoi UZ
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail bMc 1pep.akY y-,CtmwS u-mbi-ii
State or County License Q-9Q- 11429TAO
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.