HomeMy WebLinkAbout15300 cut off All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
/Date: V 2 /- 2 Permit Number:
S`u, L--L!CLL
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LL1-14-
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: 'TF',� , Q
PROPOSED IMPROVEMENT LOCATION:
Address: /S3 D 1k ,x
Property Tax ID#:_. Lot No. _
Site Plan Name: Le C a4
I p Block No.
Project Name- 19 T 77
DETAILED DES RIPTION OF WORK:
2 G C QQ r LQ E
,4
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
XElectric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
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Cost of Construction: $ d 0 - Utilities: —Sewer —Septic Building Height:
OWNER/LE SEE: CONTRACTOR:
Name fAA AT 4 µ 444 Name: njase !
Address: -! LC L-9 Company: c Y'`G ^G
City: L�— .L State:Ve Address: S
Zip Code: Fax: City: Q State:1z
Phone No. R-.�— E- Zip Code: 3 3/0 /O Fax:
Mail: , C Phone No ✓ Ds 2D2
Fill in fee simple Title Holder on next page (if different E-Mail .dSeY,v At - L
from the Owner listed above) State or County License
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.