HomeMy WebLinkAboutWillard app pg 1All APPLICABLE INFO MuST BE COIVIPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Planning and Development Services
Building and Code Regulation Division
Building Permit Application
Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Fundin8
Residential y.
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: i \0 \hl `thets lhecJL-Rn` . LI fa\m
property Tax iD #: quaa -Sos-no ao -ooo -S
Site Plan Name: +
ProjectName: u\\\Ouro
Lot No.
Block No.
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
j£Mechanical _GasTank Gas piping Shutters Windows/Doors _Pond
_ Electric _ plumbing _ Sprinklers _ Generator Roof
Total Sq. Ft of Construction:
Cost of Construction: S
Sq. Ft. of First Floor:
Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:CONTRACTOR:
. - `` `. .-Name: m`itrh€\\ ma=Zzn`\I.
Address: q`n vitr{tr€rs Cirdy.V_ DLA WV Company: \hir`res+ Air lnc.Address:2ul3ST`,`t}riharLL ScJrd&. AiuL
City: Qb`lm c^hA State:tL
Zip code: 3uqqo Fax:City: DbLthcikA ` State:EL
PhoneNo.lil-9|B-(^gho3 E-Mall:u\A zipcode: >`la!at) ' Fax: 112,-23Z-/I/f
Phone No ll z ~ 2;S2~-I l I y
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from the O`A/her llsted above)StateorCountyLcenseCALt\S850q
lf value of constructlon ls 25cO or more, a RECORDED Notice ®f C®mmencement is requlred.
lf value of HAVC ls $7,500 or more, a REcORDED Notl€e Of C®mmencement ls requlred.