HomeMy WebLinkAboutapplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: q1115
ray
S
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phoney (772) 4 41 5 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Permit Number:
Building Permit Application
Residential v
Commercial
E L G LTfZl CAL
PROPOSED IMPROVEMENT LOCATION:
Address: "1U� — D1pa%1E. DR.'t t �'Fr', S1. LlACIE 3LACi5Z
Property Tax ID #:
'4l(o- BG►-
Site Plan Name: ,- t;0_,%\\ V F.
Project Name:
MEN
DETAILED DESCRIPTION OF WORK:
New Electrical Miter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Lot No. �
Block No.
Additianal work to
be performed under
this permit — check
all that apply -
Mechanical
� Gas lank
Gas Piping
`Shutters Windows/Doors Pond
Electric
Plumbing
Sprinklers
Total Sq. Ft of Constructi11
on.
A I � �I 7"Y7ir
Cost of Construction: C)3 .
OWNER/LESSEE:
Nlame
i Address:
Cityl
Zip Code: �c�`370 'Fax:
Phone No. 11A01'(iI439
Generator Roof Pitch
. Ft. of First Floor;
Utilities: _Sewer= Septic Building HeJght:
State: E_L_
E-Maid:
Fill in fee simple Title Holder on next page j if different
from the Owner listed above)
CONTRACTOR:
Name:
Company:
Address: 1
rd re-Ta, M
Zip Code: Lm" �%gL:� fax:
Phone No '_N19A! %3'9
E-Mail co\-, W
State or County License t,-,Q-P \-.)C-,�n
If value
of
construction 1*s
2500 or more, a RECORDED Notke of Commencement is required.
1f value
of
HAVC is $7,500
or more, a RECORDED Notice of Commencement is required,,
State: F 1 4