HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ��11
Date: 2.,U2 0.- Permit Number:
° 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 CBDG Funding
PERMIT APPLICATION FOR:
Address: 5C40 (10 T2A?F1'Y a
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Property Tax ID#: '?1/0"z — Colo - O5570 — 00o —Z Lot No. iz
Site Plan Name:
Project Name:
Block No. '
'T- Z) -- 30t7r Start;yt(JNZ) `0-t rr e/t.,CN i r2C1_1 t-- :n
.�N S`i�-�L- �S�TFLEM � 1� r�`T'�L `�—✓ /y1, �Zk L iZ�o�,
New Electrical Meter Second Electrical Meter
(Affidavit required)
C{O'NSTRUCTION, fiV'FORIIJIATIQN "'
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _.Windows/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers _ Generator ,Roof 12 Pitch
Total Sq. Ft of Construction: � , Oa 0 Sq. Ft. of First Floor: 34
Cost of Construction / 0-0 . o CD Utilities: _Sewer _Septic Building Height:
Name 6 FO r-F4E � D0 u 6 (. fit s
Address: S I o 6 &m-kA b e-zv�'
City:. f—U-(LT 'PTe--r�-C.£ State: FL
Zip Code: �" � Z Fax:
Phone No. '7 'i z— 61 % 1 — 6 -K E-
Mail:.4"Lov,` nn teY1Z(4 e -N,nL9rI -Co►-,%
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name:
Company:
Address: _
City:
Zip Code:
Phone No
E-Mail
State or County License
Fax:
State:
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.