HomeMy WebLinkAboutapplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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:
PROPOSED IMPR VEMENT LOCATION:
Address: Q 22 Q�M OV"S UJQY
Property Tax lD #: _3J_3 y" ®� ""�� Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
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 _ Windows/Doors _ Pond
Electric �lumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $
I, .ZgC>
Sq. Ft. of First Floor: _
Utilities: —Sewer _Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name 2� S
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Name: QV1 �Y1�
Address: \
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Company: Gw2� ( yY1C/ ,
City: ��(�k S G Cat State: F+!
Zip Code: 3 (V(; Fax:
Phone No. .yoC
Addres : rO1
City: Ho 1(i G P�
Zip Code: Fax:
Phone No
tate: R
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail e ( ( L %
J D C.4 On
State or County License C iI LAC(
OR I
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.