HomeMy WebLinkAboutpermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10` l(I-)-] 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: rAt44,U..C.,.
PROPOSED IMPROVEMENT LOCATION:
I
-Address: 10-7 �S 5. Qcedr, d -4-- 1 s.3
Property Tax ID #: q 5 1(- 561 - 6 a51 - 0 00 - 3 Lot No.
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
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C ive
New Electrical Meter
Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
A 5712M
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:
Cost of Construction: $ 14500 . 6U
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name . C- i A e-ft
Name: Vkftce f 'A
Address: Q 7 01 5. OC.CaA i f 153
City: Tk.l1SeA 9U#'C'bt State:
Zip Code: 34 CA' S:J Fax:
Phone No. �Cf o�� N5 a _ I L( aK E-
Company: 0 L✓Yl 1 '
Address: 12-4� SE iTE 1 -
City: Forf 7t "GrP- State:`F1
Zip Code: 3� 95"�)- Fax: 335'&3 io
Phone No 3°I .;L3'Yq
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail as dJ en+cf En!5es _ S - c,mA
State or County License 4 IfAC 1,151595%
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.