HomeMy WebLinkAboutimg20211105_13335206All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
LUuvI
c 1- t` . L Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial
CBDG Funding
Residential
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
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Address: ' J O�i` C
Property Tax ID #: -4L016 ?n - O 0,'}' Lot No._
Site Plan Name: Block No.
Proiect Name:
DETAILED DESCRIPTION OF WORK:
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New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
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:
OWNER/LESSEE:
CONTRACTOR:
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Name: ' Vt --�
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City: \ 0\-r\ L\�:::l State: L-
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Zip Code: 3LV2�q() Fax: '�
City: ��a�1(Y1 C1 �j
State:
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Zip Code: la Fax:
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Mail: —®
Fill in fee simple Title Holder on next page (if different
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from the Owner listed above)
State or County License � y
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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.