HomeMy WebLinkAboutBuilding permit app, pg 1All APPLICABLE INFO MUST Bf COMPLfTfD FOR APPLICATION TO BE ACCEPTED
Date; q1 l21:2::1 Permit Number: ______ _
Building Permit Application
Planning and Development Servires
Building and Code Regulation Division Commercial ____ _ Residential __ / __ _
2300 V-,rginia Avenue, Fort Pierce FL 34982
Phone: {n21 462-1553 Fax: (n2) 462-1578
PERMIT APPLICATION FOR:
PropertyTaxlD#:________________________ l.otNo .. ___ _
Site Plan Name=--------------~---------Block No. __ _
Project Name: ______________________________ _
New Electrical Meter ____ Second Electrical Meter _____ _
I CONSTRUCTION INFORMATION;
A~nal work to be performed under this permit-check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors Pond
Electric _Plumbing _ Sprinklers Pitch ----Generator Roof
Total Sq. Ft of Construction: ______ _ Sq. Ft. qf First Floor. ________ _
Cost of Construction: $ {; 5 () 0 ~ 0 0 Utilities: _ Sewer _ Septic Building Height: ___ _
OWNER/tESSEE: .
Name__::,u,<...._.~~¥,-J..>U."'4-r--:------
Address::JL.rl;i~';f]!b.k;,!l/!,,~!5:}_~----~
City: fod?Ptif[l, State: Ji.
Zip Code: 3t.J451 Fax:. ______ _
Phone No. 171• fa l -~,;s,$5
E-Mail: ______________ _
fill in fee simple Trtle Holder on next page ( if different
from the OWner listed above)
CONTR!tCfOR:
Name:...tt'l.lllru.JL..-1:~~'lt,,,. _______ _
~;=~~a'i~~M\=~~t~ ,L,t:-
City: 6it Pivec.. State: R.,
ZipCode: $:ffSl Fax:JJ:i-it<,-3137
PhoneNo11'.lr%1· L-\IJ.1-J
E-Mail t.JoW,~ @, \.(UlOO. (!o(Yl
State or County License CAC 11111 '3 C,
H ue of constnK:tion is 2500 or more, a R£CORD£D Notice of Commencement is required.
H value of HAVC is $7,500 or mare, a RECOIU>ED Natlce of Commencement ls raquked.
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