HomeMy WebLinkAboutapplicationAll APPLICABLEINFOMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I'r"11-;L( Permit Number:
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vI of,A _ 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
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PERMIT APPLICATION FOR: i'v,e �ay-IC' a
PROPOSED IMPROVEMENT LOCATION: i7 I/l"7nI < /O6r� t A:�542�Z I <n-*4S11-Sit?-0ON.0e)b-y
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Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
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New Electrical Meter
Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
Mechanical . _ Gas Tank —Gas Piping _ Shutters
MIREMMAN
(Affidavit required)
Windows/Doors
Elettric _ Plumbing _ Sprinklers _ Generator _ Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ S a-00 . G7-1 Utilities: —Sewer —Septic Building Height:
Pond
Pitch
OWNER/LESSEE:
CONTRACTOR:
Name 64r\0.w+CA &r•►1 ru5
Name: (-n C•t. tz- C rg`�r'Yt
Company: lie
Address: t0101 S. Ocean PC ':r 9 33
City: A G"rI State: _
Zip Code: 3 11 S 7 Fax:
Phone No. Y i E-
Address: l.'XI ( 5 C
City: N L State: IL
Zip Code: q95- 2- Fax: 3 3 -33 0
Phone No
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail ado�Cn �'�S¢5 *� G�Ur� Cowl
State or County License CM C Zq -j 5
If value of construction is 2500 or more, a RECORDED Notice of Commencement is regwrea.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.