HomeMy WebLinkAboutBUILDING PERMIT APPLICATION I9'' Ali h►PPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q Date: 0—,Z �,�f Permit Number: ��d.0!�
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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
PERMIT APPLICATION FOR:
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koRQ SED [MP OVEMEMT LOCAL IClNH
Address: 0 . 'Lpo .,
Property Tax ID#: q32— S Q 6 0 35 — 000-5 Lot No.
Site Plan Name: Block No.
Project Name: IYJ C_Mx y).
DETAILED DES"CRIPTION CIF WORK
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New Electrical Meter Second Electrical Meter (Affidavit required)
CaNSTRVCTIQN INFQRMATIO
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IIAdditional 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: O Sq. Ft. of First Floor:
® Cost of Construction:$ , ,,�q Utilities: _Sewer _Septic Building Height:
OWNE�tJtESSEE _ toNTRACTQR
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Name ,.`. +a =e, . • i Name:
Address: C}:: b. Company:
City: . .,; Stater, Address:
Zip Code: Fax: City: _ State:
Phone NO. Zip Code: Fax:
E-Mail: dam Thone No
Fill in fee simple Titl Holder on next page (if different E-Mail
from the Owner listed above) State or County License
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.