HomeMy WebLinkAboutPERMITAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I l ~ 11- ;'" / Permit Number:
�LLB G(M�4 14
R r;, 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 X Residential
CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
-Address: 9 803 5. Occoo pr PoLrce 1 z-4 it 4 So ;� - 5-01- 071 Y- 000
Property Tax ID #: Lot No.
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
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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: $ 6 106 .i
(Affidavit required)
Generator
Sq. Ft. of First Floor:
Block No.
Windows/Doors ^ Pond
Roof Pitch
Utilities: —Sewer _ Septic Building Height:
OWN ER/LESSEE:
CONTRACTOR:
Name_ U<'WG5 -T_Sl14#N -1AC
Name 00JJ 115>1
S
Address: Gi$Q f S . 044&ft DE
City: 'S4tA6t.n l&t.0-G4 -State: _
Zip Code: 3,44S07 Fax:
Phone No. 30 E-
Mail:
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Address- I 7_91 6 St
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City: T OCE _4+ t-l&6ti
zip Code: 'b4j.s2_ Fax:
Phone No
State: F�I
335 -33i 0
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail coyn
State or County License C19'1 C� I �•c( r[q$�
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.