HomeMy WebLinkAbout2021-11-08_084548.pdfAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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:
PROPOSED IMPROVEMENT LOCATION:
Address: 7&M G4Le2Y1b9ieR Ct R
Property Tax ID#: 3319 -700 -'00r000-1
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
QC2mev►t 0
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors
_/
_ Electric i' Plumbing _ Sprinklers _ Generator _ Roof
Total Sq. Ft of Construction:
Cost of Construction. $ 196)
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic
Lot No. 6/
Block No.
Building Height:
Pitch
OWNER/LESSEE:
CONTRACTOR:
Name-' a LRN-Al
Name: 510Y411 `1Qneg
Address: k, 6etenbeie.. C,'R
Company: uPlc)2 I �G
City: Vo ev St Luca e State: �L
Zip Code: 3 � Fax:
Phone No. llk- 113 - 32,24 E-
A
Address: Q-2 flI NO) D 03y 71 V 0
City: of�1�Stp 4�f�' State: FL
Zip Code: atf Qa Fax:
Phone NoV2 7%7- OOCD
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail eu&etl f ("A C (! V90 00. &0O ,n
State or County License CFf- Na9 OR
nr vawe or consrrucuon is [Suu or more, a KtCUKDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.