HomeMy WebLinkAboutapplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8� /7tV ,24 Permit Number:
-_- Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial _
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
Residential
PERMIT APPLICATION FOR: �f'�r -'rnor n0✓�%�% 9hr%U J%S T-AeG'TA M'!</�J
PROPOSED IMPROVEMENT LOCATION:
Address: 5/O(o �IJeHA �A.td L�. fT� �<E.2L�E t`�- 341��'2 - -75/g P-
Property Tax ID #: eVOa - 1pD,1-2 - D/CAS - OOD- .6 Lot No. eaAID
Site Plan Name: •-lA/A/ A-1 Z% wee, S;7�7-,ES aZT Block No.
Project Name: -8116J.�'A-Al -AJ
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
°V/ f �v.'6H i �X /O7 k/S
(Affidavit required)
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 X Roof Pitch
Total Sq. Ft of Construction: &6-2 "O Sq. Ft. of First Floor:
Cost of Construction: $ Oo &P-z). -0 - Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name "I
�)0.11
Name: •c%�55� 1,5�Al&wey,,4 .
Address: 'S�l OCv
I,Lt ,
Company: •LDS AA20yP LLL •
City: -:R�(--�-
Zip Code: 3'-fa `b'a- Fax:
Phone No. --1-1 2 -?f-p(.p
State:
E-
Address: ylk) � 9�& IS� I - F-
City: 14 4AZO CH State: u_
Zip Code: / �f�i�'a.��5��� Fax: �Feer
Phone No
Mail: C\ dA 5,� r- ZQ91t,--,C 1 . CJQ:,
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail 064, CDr»
State or County License f-Ci��DA