HomeMy WebLinkAboutApplication (2)All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 D ?(" -mac l Permit Number:
V P, ° . 0- Building Permit Application
Planning and Development Services
Building and Code Regulation Dlvlslon Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 349s2
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
I PROPOSED IMPROVEMENT LOCATION:
Address:
Property Tax ID #: 1 -- a - 000/- D (DO 7 Lot No.
Site Plan Name: Block No.
Project Name: CAPRtPi` 0
I DETAILED DESCRIPTION OF WORK:
New Electrical Meter _ Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION: I
Additional work to be performed under this permit- check all that apply:
—Mechanical _ Gas Tank —Gas Piping _ Shutters _„ Windows/Doors � Pond
Electric _ Plumbing . _ Sprinklers
Total Sq. Ft of Construction: 7 5[
Cost of Construction: $ 15T Q
_ Generator "-A�oof 4 1 Pitch
Sq. Ft. of First Floor:
Utilities: `Sewer _ Septic Building Height: - 17 l
OWNERAESSEE:
CONTRACTOR:
Name Lo
Name
Address; JQ O d Wen,C �
Company: _k . A . Reli a /i n i'l
City:Fo(f iherer. State: FL
AdOZ s : lri 4�3 S s L
Zip Code.3 � Q Lf S „ Fax:
city:.� .1 �s � 71 state: FL
Phone No. E-
Zip Code: 33 4'to 'Cl Fax:
Mail:
Phone No -
Fill In fee simple Title Holder on next page (if different
E-Mail 0 j�/z (j m A() - i eTr i ct , m; i C Gz>M
-`
from the Owner listed above)
e
State or County License _CC6 I3361(�G
�...�.�������.�► ar more, a Rea "Rmw nonce or commencement IS required.
B value o? HAVC Is $7,500 or more, a RECORDED Notice of Commencement Is required.