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HomeMy WebLinkAboutBuilding PERMIT APP 1N ti All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: _ i�� I 81goal Permit Number: UN® Mai y + r C61 0-Y1 N N: a Building Per 'it Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce Ft 34982 Phone: (772) 462-1553 Fax: (772) 452-1578 Commercial Residential PERMIT APPLICATION FOR: � lec,+r i c o,,.,I PR,0POSED IMPROVEMENT LOCATION: � _ Address: Property Tax ID #11 Site Plan Name: Project Name: Aq DETAILED. DESCRIPTION OF WORK: New Electrical Meter Lot Nov. 36L Block No. "iCa-1�. OQ124Q. � /LIS2J� uJ.U�3� O�Yx�_ 6YCwYJ�rnG Second Electrical Meter (Affidavit required) CONSTRUCTION INFORMATION: 1; Additional work to be performed under this permit -- check all that apply: Mechanical � Gas Tank � Gas Piping Shutters Windows/Doors Pond Electric _ Plumbing Total Sq.. Ft of Construction: Cast of Constructions: $ ^�, � 00 _,,,,, Sprinklers Generator Roof Pith Sq. Ft. of First Floor: Utilities; Sewer septic Building Height: OWNER/LESSEE: CONTRACTOR: Name 'fD `�vsb3p Name: YYIP.S Address: 50111%cm 1 lame MVP. Company: HMWGLEJ 4?E,iTlC0.� otv-.-,F+.., Pi, r State: Address:, IUIU W.Zip Cade; 3�lg51 Fax: City: �state: Phone No. 7'ld- &()�L- Zip Code: Fax: E-Mail.• Q-puteos6if boa4s, Phone No TI;L­- x4 6i-&,9kag Fill in fee simple Title Holder on next page if different E-Mail �QY11BSf�`D,�UiO� aoI. cc)YI') from the Owner listed above) State or County License Lo��1 If value of construction is 2500 or more, a RECORDED Notice of Commencement is required, If value of HAVC is $7,500or more, a RECORDED Notice of Commencement irequired.