HomeMy WebLinkAboutBUILDING PERMIT APPLICATION t .
All APPLICA LE IN O MUST.BE COMPLETED FOR APPLICATION TO BE ACCEPTED ,l
Date: 9b - Permit Number: C 09- oo«J
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a. • ` ° `�`"" 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:
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Property Tax I D#: (2- $OI . 0006 - MID -$ Lot No.
Site Plan Name: '"� Block No.
Project Name: �x �.a et -
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DET�ltLEDDESCRtPTf�}N',;C�F�1JORK .
New Electrical Meter Second Electrical Meter (Affidavit required)
LONSTt�U_CTl>0_ fib 1�4FORi�/IAT�C+N i
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _windows/Doors Pond
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$_(OM-CO Utilities: _Sewer _Septic Building Height:
flfER/LESSEE j CONTRACTOR
Name A. -fi Name:
Address: -7IS 5 _orj�tAS Company:
City:fnYl ?iery State:-rX_ Address:
Zip Code:3& 947• Fax: City: State:
Phone No.-7-)I- - Oki e( "1•5-14 Zip Code: Fax:
E-Mail:Od./ 0_'c+ru54f
A.Lsorl. C-Otyi • Phone No
Fill in fee s mi p el Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License
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.