HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: F� . J . 2-0 2-1 Permit Number:
J' fir- v
y 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
1 PERMIT APPLICATION FOR:VV��`� �LdIC� x S-1 NC-, 6O CC S �Aw At_L
PROPOSED IMPROVEMENT LOCATION:
Address:
Property Tax ID #f:��,, 11 r J WCID 0 - 2
Site Plan Name: IV IC riL�
Project Name: INJ LDS �A i E U
DETAILED DESCRIPTION OF WORK:
Z-
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
Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction:
Cost of Construction: $ "i 2F32 • LX;'
Sq. Ft. of First Floor:
Lot No. Z Z � 23
Block No. 7-IL
Windows/Doors Pond
Roof Pitch
Utilities: —Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name 1_FS i(Z
Name: U LAS
�j0L)LLt�
Address: t 1t-ii� IZ-A- tA1 C L-Q
Company: - `L
iLE L
City: — - 5 V-- State: _
Zip Code:. �!-Il) 5 Z Fax:
Phone No. V"� Z • 2-15 • Z \ 1
E-Mail: N&A-o 61 Aitoo. l '. _
Address: Abby A 1&) S
I -A
City: :ff V
Zip Code: 3y�))Lj Fax:
Phone No Z .
E-Mail el. -WC
State or County License 3)
state -
(!!� C_Z+''`
LV i
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
If value of construction is 2500 or more, a RECORDED Notice of Commencement is requirea.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.