HomeMy WebLinkAboutFerrell - PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: - L4 - 202, Permit Number:
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` Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential YK-1--S
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: Hoc.- Ac, C6a-V1-0C4
PROPOSED IMPROVEMENT LOCATION:
Address: . t` . Gif Qn��� v,r� Di• r �l SA- . -L 3i. q52
Property Tax ID #: 34 242 - -193 01 1 - QDQ -Y `t Lot No. 1 `�
Site Plan Name: 1(_Q, J �Gi g _ L1 Block No.
Project Name:
11f ir�-
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
Additional work to be performed under this permit —check all that apply:
Mechanical T Gas Tank Gas Piping Shutters Windows/Doors Pond
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ -530 6 , Did
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name: I/tl1 Lin
Address: j t(�rrZt'' N ��.
Company: FM 00;kylcr � J���r 3d�'i i�P+ cs,�3
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City: State: -I--
Zip Code: 5Z Fax:
'3i.j�
Phone No. (a4% — 211 - 4001 E-
Address: Z4��� z4cf�' 4Ve- �'�. cJ
City: Ygm PA 'F� State: (
Zip Code:.323Cpl Fax:
Phone No224 q 7
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed abode)
E-Mail +!9:j ��16 ,�cgi �-. (om
State or County Licensee 130 16
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.