HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: S 1 1`i � a)a
17
Planning and Development Services
Building and Code Regulation Division
00 Virginia Avenue,, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462
PERMIT APPLICATION FOR:
PROPOSED IMPROVEM
Address:
Property Tax ID #:
Site Plan Name:
Project of
4
ENT L
PAI
Permit Number:
Building Pen mit Application
commercial
E L F, CT ?w I(lk L
OCATION:
eTZ Pc N E a
Residential
.s= No"i -" 5CQ - 5�" 9 Lot No*
DETAILED DESCR.IPTION OF WORK0
:
:�s�ina 1�C�amo s�onel on I�Oc�mn ex� n
� . 11111111[ya
5
k�
Block Na.
ba lymm
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 Windows/Doors MENFang
I
Electric � Plumbing _ Sprinklers41
_Generator Roof Pitch
Total Sq. Ft of ,Construction: Sq. Ft, of First Floor:
Cost of Construction; $ <8 "6 W Utilities; _ Sewer _Septic Building Height:
FnxIVNER��.E55EE: � CONTRACTORI,
Name Ste. ok tS5 Name: Drr1e�,,ME
Address: -F kmmlo. %4 P Company: C�yICQ.\
City: ) � state**T�, Address: l() \f� \At
Zip Code: 2)� Fax City: '?ierC5tate:r
Phony No. Zip Code-, ���L� off- Fax: lags
,E-Maid: Phone Na IloAmp 4101-'gz)ae
Fr!l in tee simple Title Helder an next page if different E-MailC,�,QQ�p1. CbfYj
from the Owner listed above) State or County License,,,-,,,,,T@-- I I I
I
-to
11 va lulm
01
C011SE CUOn is
L:Puu or more., aKtLUKUh1J Notice of commencement is required.
If value
of
HAVC is $7,500
or more, a RECORDED Notice of Commencement -irs reukedi
0