HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
SM [Lucm
VA
c h o- a E c k-- Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 91 a�o Of_lLC( P
Property Tax ID #: 333y`50t-C11q9 —GYRO `y
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Ola. uhYlZ (of ka:(V\ mu'o_
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
_ Electric i/ Plumbing _ Sprinklers _ Generator _ Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: —Sewer —Septic
Lot No.�
Block No.
)(XX
Building Height:
Pond
Pitch
OWNER/LESSEE:
CONTRACTOR:
Name Me 6i 11
Name: fah
Addres : 1120 'S
Company: ieoe( N G
City. c; State: F6
Zip Code: 0/ 10 Fax:
Phone No. i�o2 ~ oZ
Address:_(,��1()� 1)fZOiJ�`L �
City: I_0 e_+ t] 1Ur C State: 1FL
Zip Code: 3k7ri6 Fax:
Phone No 771 Op1'0
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail Qv-"( (ilnC
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State or County Licensec FE L? O 91
IT value of construction is z5uu 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.