HomeMy WebLinkAboutScan0029All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -7 13 ~ ;L-f Permit Number:
x
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: WecknI-Ca-(
PROPOSED IMPROVEMENT LOCATION:
Address: 30 Oe es 131vrk Pair c.e.f .1) SDI - Ot{ - 000 - a
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Q'ko+-t` 3 4V& ILt n,P- 5+ Coo LAA�t- 10
,- ` . -
New Electrical Meter Second Electrical Meter,
CONSTRUCTION INFORMATION:
(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 — Sprinklers J Generator — hoof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ q S60 .
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name -"I-AAAoo5k.
Name: Car6iA
Address: 4,03 WeAtleS SNA
Company: Dodd, o�w Se5 j7iA G
City: State:
Zip Code: - ,4CI S 7 Fax:
Phone No. - $ I g 19 3
1 �i
Addre s• � �-Ql (0 5C4.4-w, 4 1 & I Z --
City: DJ` 51 l--�Gt �' State: I
Zip Code: 34eWi , Fax: 33 5 ~33 ►y
Phone No 3M- -13 14
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail_d 06Uf4\4eCg n &e', e JOCI - ice
State or County License C12NC I A'I g °15
if value of construction is 2500 or more, a RECORDED Notice of commencement is requires.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.