HomeMy WebLinkAboutBUILDER PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 421 a ( Permit Number:
J
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Commercial
CBDG Funding
Residential
PROPOSED IMPROVEMENT LOCATION:
Address: q�yoGoJfhC)ce�n�r Vtitly0°� fr)cwJbu S I) ✓se✓�r�eua ,�, 9�7
Property Tax ID #:
Lot No.
Site Plan Name: Block No.
Project Name: nnc " Ocss
I DETAILED DESCRIPTION OF WORK: I
M
ele qlr('C War- hec-�-er ' -- I
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit - check all that apply:
_Mechanical
_ Electric
Gas Tank
_ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $
(Affidavit required)
Gas Piping _ Shutters _ Windows/Doors _ Pond
_ Sprinklers _ Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic . Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameeoMn)Jnrfv INkSf rzij L siyyy_✓Cr CovnPCA.
Name: Ibipr%rG,//�
Address: VD EUI V -- P•+-Q--501
Company:Alueuh r I'lurnla' , }6Q I✓� 45�.� CowSt
City: Lcx i pi }o A State:
Zip Code: �0507 Fax: g.;9'-,)6 'a?05-
Phone No. -3 g 7 -S3 /g E-
Addreess:96 7 Nil Pere s�_
city: PS State: rl -
Zip Code: 3yQ Fax:
Phone No7T2-201-q- -
Mail: Wg, Ccrsaik <JLi • corn
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mailkoe
Ojer P 1. 11 C GQ M
State or County License C /4/3N C%
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.