HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dater I' 12 I Permit Number:
do Wl CUI
Building Permit Application
Planning add Development Services
Building and Code Regulation Division Commercial Residential
230 urryinia Avenue, Fort Pierce Ft 34982
Phone (7R) 462-1553 Fax (SR) 462-1579
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address. aN - hi'.C+4D a r�
Property Tax IN n. iYG1-6n/-tz vy- e[x; -I Lot No. 2
Site Plan Name: Block No. IZ
Project Name:
DETAILED DESCRIPTION OF WORK:
PP
\! Vjj r'---C) f
New Electrical Meter Second Electrical Meter (Affidavit equital
CONSTRUCTION INFORMATION:
Additional work to be performed Under this permit- check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters "Indows/Dxrs _Pond
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Toni SA;R of Construction: SIT Ft. of First Floor:
Cast of Construction:$ utilities: _Sewer _Septic Building Helena
OWNER/LESSEE:
CONTRACTOR:
Name AliaN m Col
Name: `,nrkc reeDe
Address: MI Ack r 4 ev S{-
Company:
City: Ist G.-! State: LL
Zip Code: 3V4k1 Fax:
Phone No. 7)J-S74-/2SQ
fiddress:']aai-s't
City: QSi �: i no T Stater
ZIPCm1e: Puator Fax:
Phone No(- L` S Ei -t7 L
E-Mail: A[n)h{�r %P�//Sn .{L.Ar•f
Fill In fee almpk Title Nolder on neat Pagel g different
from the Owner listed above)
E-Mai1ft
State or Count Rcensis 9Rz r,
If "IUD 0 OWnStrUsAugn IS ZEKHJ Or
teeter".
If"IW 0 HAVCIs $7,500 ar morema RECORDED Nodttaf Commencement Is required.