HomeMy WebLinkAboutBuilding Permit App - Revised Page 1All 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 CBDG Funding _________
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: __________________________________________________________________________________________
Property Tax ID #: _________________________________________________________________ Lot No.__________
Site Plan Name: __________________________________________________________________ Block No. _______
Project Name: ______________________________________________________________________________________
DETAILED DESCRIPTION OF WORK:
_________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
New Electrical Meter __________ Second Electrical Meter_______________ (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit – check all that apply:
__Mechanical __ Gas Tank __ Gas Piping __ Shutters ___ Windows/Doors ___ Pond
__ Electric __ Plumbing __ Sprinklers __ Generator ___ Roof __________ Pitch
Total Sq. Ft of Construction: ___________________ Sq. Ft. of First Floor: _________________________
Cost of Construction: $ _____________________ Utilities: __ Sewer __ Septic Building Height: __________
OWNER/LESSEE: CONTRACTOR:
Name__________________________________________
Address: ________________________________________
City: _________________________________ State: ___
Zip Code: ______________ Fax: ____________________
Phone No.______________________________________ E-
Mail:________________________________________
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: ________________________________________
Company: _____________________________________
Address: _______________________________________
City: ______________________________ State: ____
Zip Code: ________________ Fax: __________________
Phone No______________________________________
E-Mail_________________________________________
State or County License___________________________
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.
X
Re-Roof Shingle
1431-701-0119-000-6
H
13& 14
2400 N 47th St, Fort Pierce, FL 34946
615701-Mackey
SHINGLE RE-ROOF - REMOVE & REPLACE - Atlas ProLam Shingle Hearthstone Gray FL16305-R10, Summit 60
Underlayment (2 layers) FL21350-R4, 35 SQ's, 6/12 Pitch, ***Inspections completed By Private Provider Beryl
Engineering***
X
21,300.00
3500
Harry Mackey
2400 N 47th Ave
Fort Pierce FL
34946
(772) 979-5980
bishophmackey@gmail.com
Donald Bouchard
RoofClaim.com
1405 SE Village Green Dr. A5
Port St Lucie FL
34952
772-742-5535
permit@roofclaim.com
CCC1332081