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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION _________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ____________________ Permit Number: _____________________ 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: PROPOSED IMPROVEMENT LOCATION: Address: __________________________________________________________________________________________ Property Tax ID #: _________________________________________________________________ Lot No.__________ Site Plan Name: __________________________________________________________________ Block No. _______ Project Name: ______________________________________________________________________________________ DETAILED DESCRIPTION OF WORK: New Electrical Meter __________ Second Electrical Meter_______________ 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 __ Generator ___ Roof __________ Pitch Total Sq. Ft of Construction: ___________________ Sq. Ft. of First Floor: _________________________ Cost of Construction: $ _____________________ Utilities: __ Sewer __ Septic Building Height: __________ OWNER/LESSEE: CONTRACTOR: Name__________________________________________ Address:________________________________________ City: _________________________________ State: ___ Zip Code: ______________ Fax:____________________ Phone No.______________________________________ E-Mail:________________________________________ Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Name:_________________________________________ Company:_______________________________________ Address:________________________________________ City: ______________________________ State:____ Zip Code: ________________ Fax: __________________ Phone No_______________________________________ E-Mail__________________________________________ 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. 8/3/2021 x Plumbing - Water Heater Replacement 9425 Poinciana Ct, Fort Pierce, FL 34951 1334-503-0036-000-4 34 Remove and replace 50 gallon, electric water heater located in the garage. 1,251 Scott Ritzema Adam Sampson 9425 Poinciana Ct Southpaw Plumbing & Metering Services, LLC Fort Pierce 1458 SW Bartell Ave 34951 Port St. Lucie FL (386) 225-0249 34953 sndritzema@yahoo.com 772-486-0914 info@southpawwater.com CFC1428285