HomeMy WebLinkAboutapplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: T /IO ! ;L. I Permit Number:
9�' L L1__YQ _ _1 .
P °� g pp Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 452-1553 Fax: (772) 452-1578
PERMIT APPLICATION FOR: Ike a.nlC�
PROPOSED IMPROVEMENT LOCATION:
Address: lR� Ne+kles eIvdk 'Farce+DSO?-Sol-o�S�-Ooo+�-S
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK: I
k iPr I Ike
New Electrical Meter Second Electrical Meter,
CONSTRUCTION INFORMATION:
u
(Affidavit required)
Additional work to be performed under this permit -check all that apply:
Mechanical Gas Tank _ Gas Piping _ Shutters Windows/Doors _ Pond
Electric Plumbing T Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 4646 •� Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Me, d.! L-tc .r'e Name: V6AC-G 9, CoE�iil�
Address: 1401le-5 givot Company: D0.AJ ert+er nS¢S
City. 5fA1 Statef I Address: SE �i^ rG ptU
Zip Code: 3445-7 Fax: City: Or+ S+ "(A Stater
Phone No. 36 } - sC! 5 }�j Zip Code: 3�f�1 S a Fax: _ 33S ~33_10
E-Mail: Phone No 319' a3 y
Fill in fee simple Title Holder on next page ( if different E-Mail Ai)oU eA-kCorj kse COm
from the Owner listed above) State or County License_ cmc 1 d k 1155
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.