HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I - I ! - obi Permit Number:
LU�a111
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: M CCAC R I-C
PROPOSED IMPROVEMENT LOCATION:
-Address: 5'$8 NV4(eS 61VJ- Pastel mod- soa-SOI- 67-7y- 6LM-
Property Tax ID #: Lot No.
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
-i-
l i ke.'"47-or l i k e
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit - check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ - 41900,
+ to
(Affidavit required)
Generator
1G177 R.a
_ Windows/Doors Pond
Sq. Ft. of First Floor.
Roof Pitch
Utilities: —Sewer —Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name O"01.f 610tte,
Name: etAce. R. CarVn
Address: 5'!Rs Kkw 1{5 q1JJL
Company: L;E h ►. et5 ZAc
Address: SEn �t
_
City:an 4eel 94X_ State: _
Zip Code: 1>445.1 Fax:
Phone No. 339 ASI - 6183 E-
City: Vat Sf" Lb'4e State: -PI
zip Code: 3LC'g5l;� Fax: 3.35.3310
Phone No 39 8- 2-3 L1Y
E-Mail dodde.nt�r'�nk5a aloof . corn
State or County License L#\C 1;Lg9q f
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
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.