HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAIlAPPLICABLE INFO MUST BE COMPLETED FOR APPLTCATION TO BE ACCEPTED
Date:Permit Number:
Sr" Lu"eilE -.*,.t#
Plonning and Development Services
Building and Code Regulation Division
Building Permit Application
Commercial Residential
2j00 Virginio Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (7721462-1.578 CBDG Funding
propertyrax rD #,3\O2- - 6Oa - OC'oA - C) A a -l Lot No j 7,
Site Plan Name: Btock No. 6 Z.
Project Name: A tt a-t
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION I N FORMATION :
Additional work to be performed under this permit - check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Generator
_ Windows/Doors Pond
Pitch_ Electric _ Plumbing _ Sprinklers ffnoot 5;, !a
Total Sq. Ft of Construction: t q.7 5 Sq. Ft. of First Floor:
Cost of Constructior,' S I ?, O aO Utilities:
- Sewer - Septic Building Height: i 2'
lf value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
lf value of HAVC is 57,500 or more, a RECORDED Notice of Commencement is required.
PERM IT APPLICATION FOR:i
I o$i L
PROPOSED I M PROVEM ENT LOCATION :
* car o ?I {-y?s
OWNER/LESSEE:CONTRACTOR:
Name
Address:
City: ?orf 9\vce-State:Q!-
Zip code: lotqq ot Fax:
PhoneNo.e??-514- 1,5o4 *
Mait: '(3*.b 5()L^
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: _ .
Company:
Address:
City:State:F L
Zip Code:Fax:
Phone No 2?&. - f,
E-Mail
State or County License
qA- (s4 6?
Address: