HomeMy WebLinkAboutPermit Application Detached Garage 4
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date : I 0 a cr) '� `� � I Permit Number:
WA
V ° 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 : �CYao ar ) cA &1 c ie�v�) �
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PROPOSED I,M,PROUEMENT LOCATION , „ , , . • , ,. c , _. ., .
Address: gOo 1 6z, yvlon+ AMC_ �� l � 'Piec CQ . 'FL 3 5 9
Property Tax ID #: l 301 b0i 012 3 0007 - 01 Lot No . 2`a r 2 7
Site Plan Name : Lak-CsnjJc) o Park - uv�, -A- 714- pp Block No . 31 1
Project Name : PSI43i's Occoo, tY&CAG\ (/ C:t 3f" GhAe-e-
RETAILEb DESCRIPTION OF WORK
'Tcc, r 04 o U 6 00 ave) avl ✓ o+4-C J z, cKK
� 1J�) 6\ ` dA0'1�cv'\ se ea � s
New Electrical Meter Secona4lectrical Meter (Affidavit required ) 1
GON,STRUCTION INFOI 'llRMATION : '. „ F
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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 S Pitch
Total Sq . Ft of Construction : (o �L 4 Sq . Ft. of First Floor:
Cost of Construction : $ 02 , a � Utilities: _ Sewer _ Septic Building Height: 13 1i - I
O,WNER)LESSEE: CONTRACTOR w
Name i✓1 'a j'jS I41J4 ✓1G, Lin Name : 6r' tAy� I ✓1+
Address: I�\ In L--6 1`¢. fit' Company: cormfI1u ( 6' n
City: 0 C c.ti 9 aJ1 6 v� State : -F Address: e til k1 I a4�\ AV-<
Zip Code: 334 q w Fax: City: fiat+ La.-. r,( UX kr,,l State:
Phone No , ( °I 5q) 13 5 _ 400 c) E- Zip Code: 237� 09 Fax: 95 (
Mail : }CA nsc oh6 4 C rvl ' C . CJ ✓ r) Phone No 95 - 5C3 — 7 (Zi2V
Fill in fee simp a Title Holder on next page (if different E-Mail o oy l oo i r�)C, » cbvvl
y
from the Owner listed above) State or County License CC C / 5Z, 9 '7 y $
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 .
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