HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
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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
PERMIT APPLICATION FOR: {
PROPOSED IMPROVEMENT LOCATION: - I
Address: �, N so r -r) c
Property Tax ID #: L+ --5 -- ooc)(02 i i Lot No,
Site Plan Name: � 1 � _ Block No.
Project Name:_ � C% ro
i DETAILED DESCRIPTION OF WORK: i
New Electrical Meter Second Electrical Meter
I CONSTRUCTION INFORMATION: - I
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 Pitch
Total Sq. Ft of Construction:
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Cost of Construction: $� a j
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
i OWNERAESSEE: �f
CONTRACTOR:
Name �Aoxc -��r1 A
Name: rii'l i-
Address: �� L.- Q i�` 62
company:l�Y�s�4�r, �31 t � r
City: �� � i1 �� (�° �'� State:
Address: -,75 � i�
Zip Code: Fax:
city:: State: it L_
Phone No. �i ., {(� _^
Zip Code: SL�ICIFi Fax-.(�_F�'�-L40�5-���°-�
Phone No �'��i' t�`�#-ciG�d$Q
E-Mail:-'it��'�i%p"�a����
E-Mail �1�SCyiLyit.k OiDa ( -a- L���"'F�ei
Fill in fee simple Title Molder on next page ( if different
from the ®caner listen above)
State or County License
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if value of construction is 2500 or more, a RECORDED Notice OT LORIM-1-111811L a 4 "+G.q.
if value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.