HomeMy WebLinkAboutBuilding permit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
�-`Lo L G
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:
..
41,
�.0 OWN P1111We
_01.
Address: S S �v PSI El 340m_
Property Tax ID #: 34)4 - 5Ol GG� �`V ' Lot No.
Site Plan Name: Block No.
Project Name:
k�'x u3.. :e : �E��� :•:. l: R v, u�eceu:: l uS ��a S ua _ a v v Y l-.; 3 ` Z' y uu g ,g �� „„ •�
�
7 S�i���fl4M
=,c(-_ Z
New Electrical Meter Second Electrical Meter (Affidavit required)
....... R p3e � a�i gill
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:
•. : � • ;; 3 R � .. S >e�i�x� , utluG EPe��RC,�S�... F �. Q�ki� ,Iliy,�y�
Gv3• •• S4a C
5n n
Name U-60e__ 171 r C+ Name: cA--)n i 4f_ G-i rc�iCe-_
Address: l( o—IFi S U S hL LJ Company: —n LQc . oo S
City: State: El Address: 4-_-�5 t— t Enfc nl l SC nl'
Zip Code: Fax: City: p5, State:
Phone No.—n 2 • 335• 44Z t--4- E- Zip Code: 3- 4!Q 23 Lr, Fax: 7117.- 6C --7&35
Mail: Phone No 2 • 4 (oO • —1 ly30
Fill in fee simple Title Holder on next page (if different E-Mailer e i:>D c, .IragLaot) fspsi -(b fn
from the Owner listed above) 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.