HomeMy WebLinkAboutBUILDING PERMIT All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO� BE ACCEPTED Date: S'c PrG,Ye, 'A- 2-1 , ZL)2 s Permit Number:. � ' 904
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Building Permit Application
Planning and•Development Services
Building and Code Regulation Division Commercial Residential X,..
2366 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 CBDG Funding
PERMIT APPLICATION FOR:
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PROPOSEQ,:IMPI2�UEIUI'ENT LQC�,TIQN , ;' �. }, .;.
a. l�t�x i i 1.t:r_.L• /^`� ,.>� � £�"_3
_ Lot No, i 2
Site Plan Name: W tyl 7-e 0 r Y i2&w,74 Izr-,krci=
Block No. -;
Project Name: .�,vsrA
DETALLE Di,
[ ESCRIPTIQN QF 1tVQRK
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�C•r l�,at7� s�t Ott l� 3r tSi LL /9' L f— c�i— tu'r71' LL 112[Ul1 t� PSG a,cZ�` t,X : 776�
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New Electrical Meter Second Electrical Meter
(Affidavit required)
CQNST"RUCTlQN iNFORIVIATiON
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:$ 11. 2 r/L? Utilities: _Sewer —Septic .Building Height:
_QUVNERjLESSEE
CONTRACTQR
Name W9, rL �.
Name: t�•t}Ld�l�lC t�:}1� Y
Address: S c>6 c .L L r�A1 Act,— 11 vLaru.
Company:_.., A &,s4-7,Fr t�L71t:CL
City: de t i rDit s z Address: 7 / sit I,J �',+r
Zip Code:: ��'v��
Fax: State: Pcity: Ia�e� S_ LL�c1�` State:
Phone No. S L 1 8 2. 7 ,2 eta E- Zi Code: 1
p Fax: I7.2 log&4-2°Z
Mail: C-Al2tZL 4r-t r13L•LL C Z,vc_ C, ,a Phone No '772. &"2 v22.3
Fill in fee simple Title Bolder on next page(if different E-Mail iar-,n C,4&L&??'f F,! i7jy=, C'vas}
from the Owner listed above) State or County License E C r a"2 7 S 71
it 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.
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